Bispectral Monitoring on Mechanically Ventilated Patients

Inclusion Criteria: * Admission to the medical ICU * Intubated on mechanical ventilation * On sedation medication infusion Exclusion Criteria: * Patients with a history of chronic opioid use * Patients with end-stage liver disease at ICU admission (i.e., International normalized ratio \>1.5 and not taking warfarin and/or a total serum bilirubin 1.5 times above normal limits) * Pregnant patients * Current prisoner * Refractory shock: Mean arterial blood pressure below 65 millimeters of mercury(65mmHg) despite maximum doses of 3 pressors. Norepinephrine 70mcg/min; vasopressin 0.03 units/min; epinephrine 35mcg/min; dopamine 20mcg/kg/min and phenylephrine 350mcg/min * Inability to complete the required time for follow-up * Surgical admission diagnosis * Patients with skin conditions precluding BIS monitor sensor adherence * Patients on neuromuscular blockade infusion or benzodiazepine infusion