Transnasal Induction of Normothermia in Febrile Stroke Patients

Exclusion Criteria

• •1. Age \< 18 years old or \> 95 years.
• •2. Intubation is contraindicated.
• •3. With a coagulopathy. INR above 1.5 or PTT above 45 seconds.
• •4. Hemodynamic instability, including elevated SPB for \>5 minutes despite standard of care interventions (SPB ≥ 160 mmHg for intracerebral hemorrhagic stroke; SPB ≥ 220 mmHg for subarachnoid hemorrhagic stroke or ischemic stroke).
• •5. History of cryoglobulinemia.
• •6. History of sickle cell disease.
• •7. History of serum cold agglutinin disease.
• •8. Active/ongoing of nose bleeds.
• •9. Known or suspected pregnancy.
• •10. Participation in another ongoing investigational study.
• •11. Prisoners and/or patients for whom no LAR is available.
• •12. Patient is in airborne/droplet disease isolation protocol.
• •13. Patient is or suspected to be immunocompromised;
• •14. Low platelet count defined as \< 100k (thrombocytopenia).
• •15. Nasal septal deviations (per CT scan; any degree).
• •16. Chronic rhinosinusitis.
• •17. Prior skull-based surgery
• •18. Penetrating cranial trauma.
• •19. Recent nasal trauma or anterior base skull fracture.
• •20. Presence of cardiac arrhythmias including: sustained tachycardia defined as heart rate above 120 beats per minute, or sustained bradycardia defined as heart rate below 60 beats per minute.
• •21. Refractory hypoxemia defined as partial pressure of oxygen in arterial blood (paO2) below 60 torr or oxyhemoglobin saturation below 90% despite endotracheal intubation, mechanical ventilation, and provision of supplemental oxygen of up to 0.60.
• •22. Refractory hypercarbia defined as partial pressure of carbon dioxide in arterial blood (paCO2) above 50 torr despite endotracheal intubation and conventional mechanical ventilation.
• •23. History of cardiac arrhythmia as listed above.
• •24. BMI of ≤ 15 kg/m2 or ≥ 40kg/m2