{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:12:55Z","timestamp":1783905175131,"version":"3.55.0"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Hypothermia and Temperature Management"],"abstract":"<jats:p>\n                    Effective temperature management in critically ill patients with cerebrovascular injuries is vital. A transnasal temperature modulation device (tnTMD) has shown promise in achieving normothermia, but challenges with its dual-nostril configuration limited its efficacy. This study evaluates the efficacy and safety of a single-nostril configuration and identifies the optimal flow rate for effective cooling. This was a prospective, multi-center, open-label study of temperature reduction to achieve normothermia utilizing a tnTMD. Thirty adult patients with ischemic or hemorrhagic stroke, seizure, or metabolic encephalopathy underwent cooling with the tnTMD. Ten patients were treated with the dual-nostril configuration for 8 hours at 60 L\/min, and another 10 patients for 24 hours at the same flow rate. Ten patients were treated with the single-nostril configuration for 24 hours at incrementally escalating flow rates (30, 40, and 50 L\/min). Core temperature, shivering, and adverse events were reported. The statistical analysis compared reductions in temperature and safety outcomes across flow rates in the single-nostril cohort. The analysis also compares efficacy data from the dual-nostril treatment with those from single-nostril treatments of the tnTMD. A total of 10 patients underwent single-nostril cooling. The 40 L\/min flow rate achieved the most consistent normothermia within 4 hours, with reduced temperature burden over 24 hours compared with 30 L\/min (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.03). Cooling efficacy at 40 and 50 L\/min was similar, but 40 L\/min showed lower variance. Shivering occurred in three cases; however, no severe cases of shivering were observed. There were no severe adverse effects. The single-nostril device demonstrated efficacy comparable to that of the dual-nostril approach, with improved practicality. The tnTMD effectively achieved normothermia with a novel single-nostril design with an optimal flow rate of 40 L\/min. Given its ease of use and benign safety profile, future research should explore its applicability in non-intubated patients and in longer-duration cooling intervention.\n                  <\/jats:p>","DOI":"10.1177\/21537658261468190","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:17:06Z","timestamp":1783664226000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing Transnasal Temperature Modulation: Efficacy and Safety of a Single-Nostril Cooling Device in Critically Ill Patients"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5243-3332","authenticated-orcid":false,"given":"Melissa","family":"Wagner","sequence":"first","affiliation":[{"name":"Neurocritical Care Advanced Practice Providers, Neuro Intensive Care Unit, University of Maryland Medical Center, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Dalton","sequence":"additional","affiliation":[{"name":"Department of Neurology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dave","family":"Peprah","sequence":"additional","affiliation":[{"name":"Program in Trauma, Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason J.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA."},{"name":"Department of Neurology, Georgetown University Medical Center, Washington, District of Columbia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Alex","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery\/NABI Institute, UT Health Houston McGovern Medical School, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj","family":"Badjatia","sequence":"additional","affiliation":[{"name":"Program in Trauma, Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-023-01793-3"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-020-01044-9"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-007-0011-2"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1385\/NCC:1:2:145"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.523654"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-010-9474-7"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200202000-00036"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-64074-1.00049-5"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.521583"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.14745"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-007-9015-1"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000019910.90280.f1"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.4103\/aian.aian_12_22"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/ther.2017.0033"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-013-9948-5"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.014200"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-017-0469-5"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.revmed.2018.11.006"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-009-9280-2"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000211"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.4037\/ccn2012189"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(96)90008-2"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-011-9588-6"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-020-01036-9"}],"container-title":["Therapeutic Hypothermia and Temperature Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21537658261468190","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21537658261468190","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21537658261468190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:44:04Z","timestamp":1783903444000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21537658261468190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,9]]},"references-count":24,"alternative-id":["10.1177\/21537658261468190"],"URL":"https:\/\/doi.org\/10.1177\/21537658261468190","relation":{},"ISSN":["2153-7658","2153-7933"],"issn-type":[{"value":"2153-7658","type":"print"},{"value":"2153-7933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,9]]},"article-number":"21537658261468190"}}