MENDS Study: Trial in Ventilated ICU Patients Comparing an Alpha2 Agonist Versus a Gamma Aminobutyric Acid (GABA)-Agonist to Determine Delirium Rates, Efficacy of Sedation, Analgesia and Discharge Cognitive Status

Inclusion Criteria: * Male or female adult patients admitted to the medical and surgical ICU for critical illnesses requiring mechanical ventilation with expectation of being mechanically ventilated for greater than 24 hours Exclusion Criteria: * Subjects who are less than 18 years of age * Subjects who are pregnant (a pregnancy test will be performed on all women of child bearing age) * Inability to obtain informed consent from the patient or his/her surrogate * Subjects in the ICU due to a lack of beds elsewhere in the hospital, triage issues, or withdrawal of care decisions rather than severity of illness * Subjects admitted with alcohol or drug overdoses, suicide attempts, or alcohol/delirium tremens * Subjects who are physiologically benzodiazepine dependent, and at risk for withdrawal syndromes * Subjects with chronic pain syndromes on maintenance narcotics * Subjects treated within the last 30 days with a drug or device that has not received regulatory approval as of study entry * Subjects with a psychiatric history for which they are on neuroleptic treatment * Subjects with documented moderate to severe dementia * Subjects with anoxic brain injuries, strokes, neurotrauma, or neuromuscular disorders such as myasthenia gravis or Guillain Barre syndrome * Medical team following patient unwilling to use the sedation regimens * Subjects whose family and/or physician have not committed to aggressive support for 72 hours or who are likely to withdraw within 72 hours * Sub…