Patients take control: Self-Sedation may ease anxiety in the ICU

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Subject is acutely mechanically ventilated during the current hospitalization. 2. Subject is currently receiving a continuous intravenous infusion of a sedative/opioid medication(s) or has received at least one intravenous bolus dose of a sedative/opioid medication in the previous 24 hours (fentanyl, hydromorphone, ketamine, morphine, midazolam, diazepam, lorazepam, propofol, haloperidol, dexmedetomidine). 3. Subject must pass pre-Patient-Controlled Sedation (PCS) screening test and be assessed Richmond Agitation-Sedation Scale (RASS) -2 to +1 4. Subject Age ≥ 18 years 5. Subject or their proxy is capable of providing informed consent Exclusion Criteria: 1. Aggressive ventilatory support or prone ventilation. 2. Hypotension (systolic blood pressure \< 85 mmHg) requiring a vasopressor at a dose greater than norepinephrine or epinephrine 0.15 mcg/kg/min or vasopressin \> 2.4 units per hour. Subjects will be excluded if they require more than one continuous infusion of a catecholamine vasopressor medication simultaneously. Subjects will be excluded if the vasopressor dose was higher than norepinephrine or epinephrine 0.15 mcg/kg/min, vasopressin \> 2.4 units per hour, phenylephrine \>3 mcg/kg/min, dopamine \>10 mcg/kg/min or dobutamine at any dose in the prior 6 hours. If dopamine is being used to increase heart rate, rather than as a vasopressor for hypotension, subject will be excluded. 3. Second or third degree heart block or bradycardia (heart rate \< 50 beats/min). 4. Paralysis or other condition preventing the use of push button device 5. Positive pregnancy test or lactation 6. Acute hepatitis or liver failure (direct bilirubin \>5 mg/dL) 7. Acute stroke or uncontrolled seizures. 8. Acute myocardial infarction within 48 hours prior to enrollment. 9. Severe cognition or communication problems (such as coma, deafness without signing literacy, physician-documented dementia) 10. Assessed RASS -3, -4, -5 or RASS +2,+3, +4 11. Chronic ventilator support in place of residence prior to current hospitalization. 12. Imminent extubation from mechanical ventilator support.