S01E59 | ICECAP :Does Longer Cooling Improve Recovery After Cardiac Arrest?
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S01E59 | ICECAP :Does Longer Cooling Improve Recovery After Cardiac Arrest?
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How long should comatose patients remain at 33°C after out-of-hospital cardiac arrest?
In this episode of PRISM Rounds, we examine the icecap randomized clinical trial, which studied 1,158 comatose OHCA survivors who had already been rapidly cooled to 33°C. Patients were assigned to different cooling durations ranging from 6 to 72 hours.
Longer cooling did not improve neurological recovery, mortality, or secondary neurological outcomes. We discuss the adaptive trial design, the separate shockable and nonshockable rhythm cohorts, the meaning of the approximately 50% probability that 6 hours was the shortest optimal duration, and why this does not establish a universal six-hour protocol.
The episode places icecap in context with TTM, TTM2, and HYPERION while keeping clear that these trials addressed different temperature-management questions.
Read the study:
https://jamanetwork.com/journals/jama/fullarticle/2852508
Subscribe to PRISM Rounds on Apple Podcasts, Spotify, or YouTube, and visit:
https://www.prismrounds.com
Tags:
icecap, cardiac arrest, out-of-hospital cardiac arrest, OHCA, targeted temperature management, therapeutic hypothermia, post-cardiac arrest care, neuroprotection, neurological recovery, TTM, TTM2, HYPERION, critical care, intensive care, emergency medicine, resuscitation, ICU, fever prevention, modified Rankin Scale, PRISM Rounds