Clinical Research Directory

Inclusion Criteria: 1. English-speaking 2. Greater than 24 hours and less than 7 days of intubation in the intensive care unit Exclusion Criteria: 1. Age under 18 years on admission 2. Patients with anticipated discharge 5 days after extubation 3. Patients who are dependent for activities of daily living (ADLs) in the 30 days prior to admission 4. Patients unable to consent 5. Patients with neck trauma 6. Patients with head and neck malignancies 7. Patients with pre-existing laryngeal or tracheal stenosis 8. Patients with other pre-existing respiratory conditions such as chronic obstructive pulmonary disease (COPD), asthma, neuromuscular dystrophies, cystic fibrosis, bronchiectasis 9. Patients who had been previously intubated for an extended period of time 10. Patients who are pregnant or currently breastfeeding 11. Patients with allergies to study medications 12. Patients with a resting heart rate greater than 100 beats per minute 13. Patients with a prolonged corrected QT (QTc) interval (\>450 msec) or the use of medications that prolong the QTc interval or are associated with Torsades de pointes (with the exception of amiodarone)24 14. Patients with severe hearing impairment documented by audiometric testing