* 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 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 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 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.