A Multicomponent Intervention Program to Prevent and Reduce ICU Agitation and Physical Restraint Use

Inclusion criteria:

• Adult ICU patients (aged ≥18) with an expected ICU stay of >24 hours

• Patients who are (expected to become) agitated within the first 14 days of their ICUadmission

Exclusion criteria:

• Contra indication for dexmedetomidine use (i.e., AV-block grade 2 or 3 unless apacemaker is present, uncontrolled hypotension, acute cerebrovascular condition orknown/suspected hypersensitivity);

• Neurological patients with an (expected risk of) increased intracranial pressure;

• An intoxication as a result of drug abuse (e.g., ethanol, γ-Hydroxybutyrate,opioids, benzodiazepines);

• Support with Extracorporeal Membrane Oxygenation (ECMO);

• Difficult airway (e.g., a Cormack and Lehane laryngoscopy grade 4 view or a tumorcausing airway obstruction);

• A high risk of physical aggression towards healthcare professionals;

• No consent for long term follow up in the MONITOR-IC study;

• Not able to read or understand the Dutch language and no relatives able to assist;

• Enrolment in other sedation studies.