1. patients without surrogate or legally authorized representative able to provide informed consent. 2. patients with contraindication to core warming using an esophageal core warming device. 3. patients known to be pregnant. 4. patients with \<40 kg of body mass. 5. patients with dnr status. 6. patients with acute stroke, post-cardiac arrest, or multiple sclerosis. 7. patients with history of esophageal disease 8. patients with a baseline epinephrine dose greater than 0.6 mcg/kg/min 9. patients with atrial fibrillation, atrial flutter, or other multifocal atrial tachycardia with a heart rate greater than 110 beats per minute. 10. patients on 0.2 mcg/kg/min or more of norepinephrine

1. patients without surrogate or legally authorized representative able to provide informed consent. 2. patients with contraindication to core warming using an esophageal core warming device. 3. patients known to be pregnant. 4. patients with \<40 kg of body mass. 5. patients with dnr status. 6. patients with acute stroke, post-cardiac arrest, or multiple sclerosis. 7. patients with history of esophageal disease 8. patients with a baseline epinephrine dose greater than 0.6 mcg/kg/min 9. patients with atrial fibrillation, atrial flutter, or other multifocal atrial tachycardia with a heart rate greater than 110 beats per minute. 10. patients on 0.2 mcg/kg/min or more of norepinephrine

patients without surrogate or legally authorized representative able to provide informed consent. patients with contraindication to core warming using an esophageal core warming device. patients known to be pregnant. patients with <40 kg of body mass. patients with dnr status. patients with acute stroke, post-cardiac arrest, or multiple sclerosis. patients with history of esophageal disease patients with a baseline epinephrine dose greater than 0.6 mcg/kg/min patients with atrial fibrillation, atrial flutter, or other multifocal atrial tachycardia with a heart rate greater than 110 beats per minute. patients on 0.2 mcg/kg/min or more of norepinephrine

patients without surrogate or legally authorized representative able to provide informed consent. patients with contraindication to core warming using an esophageal core warming device. patients known to be pregnant. patients with <40 kg of body mass. patients with dnr status. patients with acute stroke, post-cardiac arrest, or multiple sclerosis. patients with history of esophageal disease patients with a baseline epinephrine dose greater than 0.6 mcg/kg/min patients with atrial fibrillation, atrial flutter, or other multifocal atrial tachycardia with a heart rate greater than 110 beats per minute. patients on 0.2 mcg/kg/min or more of norepinephrine

1. patients without surrogate or legally authorized representative able to provide informed consent. 2. patients with contraindication to core warming using an esophageal core warming device. 3. patients known to be pregnant. 4. patients with <40 kg of body mass. 5. patients with dnr status. 6. patients with acute stroke, post-cardiac arrest, or multiple sclerosis. 7. patients with history of esophageal disease 8. patients with a baseline epinephrine dose greater than 0.6 mcg/kg/min 9. patients with atrial fibrillation, atrial flutter, or other multifocal atrial tachycardia with a heart rate greater than 110 beats per minute. 10. patients on 0.2 mcg/kg/min or more of norepinephrine

1. patients without surrogate or legally authorized representative able to provide informed consent. 2. patients with contraindication to core warming using an esophageal core warming device. 3. patients known to be pregnant. 4. patients with <40 kg of body mass. 5. patients with dnr status. 6. patients with acute stroke, post-cardiac arrest, or multiple sclerosis. 7. patients with history of esophageal disease 8. patients with a baseline epinephrine dose greater than 0.6 mcg/kg/min 9. patients with atrial fibrillation, atrial flutter, or other multifocal atrial tachycardia with a heart rate greater than 110 beats per minute. 10. patients on 0.2 mcg/kg/min or more of norepinephrine