Transnasal Induction of Normothermia for Neurogenic Fever

Eligibility Criteria

• 1. Admitted to an Intensive Care Unit for a planned stay of at least 24 hours with a diagnosis of ischemic or hemorrhagic stroke, seizure, or metabolic encephalopathy.
• 2. Ages 18-85 years, inclusive.
• 3. Patient has fever ≥ 38.3°C and ≤ 38.9°C at the time of treatment initiation.
• 4. Patient is orally intubated or has tracheostomy tube and is mechanically ventilated.
• 5. Glasgow Coma Scale score of 3-11, inclusive.
• 6. Must have informed consent from the patient or the legally authorized representative (LAR) making decisions for the patient.
• 1. Intubation is contraindicated.
• 2. Weight of ≤ 100lb or ≥ 250lb.
• 3. Active/ongoing epistaxis.
• 4. Known or suspected pregnancy.
• 5. Participation in another ongoing investigational study.
• 6. Prisoners and/or patients for whom no LAR is available.
• 7. Patient is in airborne/droplet disease isolation protocol.
• 8. Patient is or suspected to be immunocompromised.
• 9. Nasal septal deviations (per standard of care CT scan; any degree).
• 10. Chronic rhinosinusitis.
• 11. Traumatic brain injury.
• 12. Prior skull-base surgery.
• 13. Penetrating cranial trauma.
• 14. Recent nasal trauma or anterior base skull fracture.
• 15. Any condition for which transnasal air flow would be contraindicated.
• 16. Refractory hypoxemia (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).
• 17. Refractory hypercarbia (partial pressure of carbon dioxide in arterial blood (paCO2) above 50 torr despite endotracheal intubation and conventional mechanical ventilation).