Liquidity remains a primary concern as the company continues to burn cash, reporting a negative free cash flow of $2.8M in 2026Q1 and an OCF/NI ratio of 0.78.
| Cash from Operations | -13.71M | -13.6M | -16.01M | -10.29M | -7.79M | -5.11M | -5.57M |
| Operating CF Margin % | - | -1102.03% | -11857.04% | - | - | - | - |
| Operating CF Growth % | 25.4% | 15.04% | -55.63% | -31.96% | -52.41% | 8.22% | - |
| Net Income | -11.9M | -12.15M | -24.83M | -26.23M | -12.19M | -4.6M | -3.28M |
| Depreciation & Amortization | 0 | 18K | 0 | 0 | 0 | 0 | 0 |
| Stock-Based Compensation | 457K | 624K | 887K | 1.93M | 1.31M | 14K | 0 |
| Deferred Taxes | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Non-Cash Items | 386K | 266K | 6.94M | 11.14M | 533K | 148K | -3.19M |
| Working Capital Changes | -2.65M | -2.36M | 992K | 2.88M | 2.55M | -680K | 890K |
| Change in Receivables | -69K | -125K | -112K | 12K | 4K | 0 | 0 |
| Change in Inventory | -13K | -66K | 0 | 0 | 0 | 55K | 137K |
| Change in Payables | -2.68M | -2.1M | -1.28M | 2.44M | 1.55M | -297K | 225K |
| Cash from Investing | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Capital Expenditures | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| CapEx % of Revenue | 0% | - | - | - | - | - | - |
| Acquisitions | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - |
| Other Investing | 0 | 0 | 0 | 0 | 0 | 105.57M | 0 |
| Cash from Financing | 17.76M | 23.76M | 17.65M | 10.41M | 7.33M | 2.82M | 4.89M |
| Debt Issued (Net) | -45K | -67K | -4.41M | 3.53M | 3.48M | 2.82M | -133K |
| Equity Issued (Net) | 17.01M | 23.83M | 17.44M | 6.61M | 10M | 0 | 5.03M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Financing | 795K | 0 | 4.62M | 272K | -6.15M | 0 | 0 |
| Net Change in Cash | 4.05M | 10.16M | 1.64M | 129K | -463K | 471.61K | -680K |
| Free Cash Flow | -13.71M | -13.6M | -16.01M | -10.29M | -7.79M | -5.11M | -5.57M |
| FCF Margin % | -954.46% | -1102.03% | -11857.04% | - | - | - | - |
| FCF Growth % | 9.67% | 15.04% | -55.63% | -31.96% | -52.41% | 8.22% | - |
| FCF per Share | -0.35 | -0.66 | -42.75 | -118.65 | -149.50 | -98.04 | -106.82 |
| FCF Conversion (FCF/Net Income) | 1.15x | 1.12x | 0.64x | 0.39x | 0.64x | 1.11x | 1.70x |
| Interest Paid | 0 | 0 | 553K | 1.13M | 6K | 0 | 1K |
| Taxes Paid | 0 | 0 | 3K | 0 | 1K | 0 | 1K |
Clinical trial funding dependency
As reported in financial statements, ICU's operating cash flow consistently trails net income, with the OCF/NI ratio fluctuating significantly, such as the 0.78 observed in 2026Q1, indicating that the company's cash burn is not merely a function of accounting losses but reflects ongoing operational cash requirements.
The persistent gap between net income and operating cash flow suggests that non-cash expenses and working capital movements are insufficient to bridge the divide between accounting losses and actual cash depletion. Investors should monitor this divergence as it implies that the company's cash burn is deeply embedded in its core operating structure rather than being a temporary accounting artifact.
Based on SeaStar Medical's reported figures, the company has maintained a consistent negative free cash flow trajectory, with quarterly outflows reaching $2.8M in 2026Q1, underscoring the substantial capital requirements necessary to sustain its clinical development pipeline in the absence of meaningful self-sustaining commercial revenue.
The lack of positive free cash flow is a structural reality of the current pre-commercial phase, where clinical trial expenditures dominate the cash flow statement. This trajectory suggests that the company remains entirely dependent on external capital markets to fund its operations until the NEUTRALIZE-AKI trial reaches a definitive conclusion.
According to recent SEC filings, ICU's working capital changes have been highly erratic, swinging from a $1.8M inflow in 2024Q2 to a $1.3M outflow in 2025Q4, which highlights the inherent difficulty in managing cash cycles for a firm in the early stages of commercializing specialized medical devices.
These fluctuations in working capital appear to be driven by the timing of inventory stocking and the collection of receivables from a limited base of pediatric clinical sites. Such volatility warrants further investigation, as it may mask underlying trends in the actual clinical adoption rate of the SCD technology.
Based on the provided cash flow data, the company's reliance on stock-based compensation, which reached $434.0K in 2024Q1, serves as a non-cash mechanism to preserve liquidity, effectively obscuring the true extent of the cash burn required to retain talent during this critical clinical development phase.
While stock-based compensation helps mitigate immediate cash outflows, it represents a significant dilution risk that is not fully captured in the headline operating cash flow figures. Analysts should interpret these adjustments as a necessary trade-off that prioritizes short-term cash preservation at the expense of long-term shareholder equity.
Quick answers to the most common questions about buying ICU stock.
SeaStar Medical Holding Corporation (ICU) generated $-13.6M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
SeaStar Medical Holding Corporation (ICU) reported negative free cash flow of $13.6M in 2025, indicating capital requirements exceeded cash from operations.
SeaStar Medical Holding Corporation (ICU) spent $0.0M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.