Sedation Management in Pediatric Patients With Acute Respiratory Failure (The RESTORE Study)

Inclusion Criteria: * At least 2 weeks of age (and at least 42 weeks post-menstrual age) and less than 18 years of age * Intubated and mechanically ventilated for acute lung disease Exclusion Criteria: * Cyanotic heart disease with unrepaired or palliated right to left intracardiac shunt * History of single ventricle at any stage of repair * Congenital diaphragmatic hernia or paralysis * Primary pulmonary hypertension * Critical airway or anatomical obstruction of the lower airway * Ventilator dependent upon pediatric ICU admission * Neuromuscular respiratory failure * Spinal cord injury above the lumbar region * Pain managed by patient-controlled analgesia or epidural catheter * Patient transferred from an outside ICU where sedatives had already been administered for more than 24 hours * Family or medical team has decided not to provide full support * Enrolled in any other critical care interventional clinical trial concurrently or in the 30 days before study entry * Known allergy to any of the study medications * Pregnancy