Table 1 AVERT inclusion and exclusion criteria

• 18 years or older

• Premorbid modified Rankin Score of 3, 4 or 5

• Recruited within 24 hours of stroke onset

• Deterioration within first hour of admission, resulting in direct admission to ICU, a documented clinical decision for palliative treatment, or immediate surgery

• Admitted to stroke care unit

• Conscious – reacts to verbal commands as a minimum

• Concurrent diagnosis of rapidly deteriorating disease (e.g. terminal cancer)

• Unstable coronary or other medical condition judged by investigator to impose hazard to patient if involved in trial

• Systolic blood pressure < 110 or > 220 mmHg

• Oxygen saturation < 92% (±supplemental oxygen)

• Resting heart rate < 40 or >110 bpm

• Temperature > 38.5°C

• Enrolled in another intervention trial