Guthrie Participates in Largest U.S. Study on Cooling Treatment Following Cardiac Arrest

Researchers at Guthrie participated in the largest U.S. clinical trial to examine how long patients should be cooled following cardiac arrest, helping advance understanding of a treatment used to reduce brain injury and improve survival.

The Influence of Cooling Duration on Efficacy in Cardiac Arrest Patients (ICECAP) trial included 1,158 patients at 71 hospitals across the United States between 2020 and 2025. The study evaluated whether longer periods of therapeutic hypothermia, also known as targeted temperature management, improved outcomes for adults who remained unconscious after their hearts were restarted following cardiac arrest.

Therapeutic hypothermia has been used for more than two decades to help protect the brain after cardiac arrest by lowering body temperature and slowing metabolic activity. While previous studies have shown mixed results, researchers sought to determine whether extending cooling durations from six to 72 hours could improve recovery.

The study found that longer cooling durations did not significantly improve overall outcomes. However, researchers noted higher-than-expected survival rates among some patients who historically have had poor outcomes, including those who did not receive a defibrillator shock during resuscitation.

Because the trial included a broad range of patients and injury severity levels, researchers will continue analyzing the data to determine whether specific patient groups may benefit from different cooling strategies.

The study's findings contribute to ongoing efforts to improve care for the more than 250,000 Americans who experience out-of-hospital cardiac arrest each year.

Local Investigators: Jon Rittenberger, MD; Adam Breslin, MD; Carina Sorenson, MD; Christopher Berry, MD and Zachary Dewar, MD

Additional authors: William J. Meurer, Sharon D. Yeatts, Romergryko G. Geocadin, Akash Roy, Clifton W. Callaway, Viswanathan Ramakrishnan, Scott M. Berry, Angela F. Caveney, Sara Meyer, Nia Bozeman, Deneil M. Harney, Mickie Speers, Valerie Lynn Willis Stevenson, Cemal B. Sozener, Mohamud R. Daya, David G. Beiser, Jonathan Elmer, Imad R. Khan, Karen G. Hirsch, J. Hope Kilgannon, Michelle Nassal, Nicholas J. Johnson, Rachel Beekman, Teresa L. May, Jeremy Brown and Robert Silbergleit.

Funding/disclosures: This study was supported by the National Heart, Lung, and Blood Institute and the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (grants UH3HL145269, U24HL145272, U24NS100659, and U24NS100655).

Paper cited: “Duration of therapeutic hypothermia after out-of-hospital cardiac arrest: the ICECAP randomized clinical trial,” The Journal of the American Medical Association. DOI: 10.1001/jama.2026.10247