The INSPIRE Study looks at one of the most common and critical moments in intensive care: placing a breathing tube when someone is extremely ill. Doctors use medications to keep patients comfortable during intubation, but there are two different approaches, using a sedative alone, or using a sedative plus a medication that temporarily paralyzes the muscles. Each option has potential benefits and risks, and it’s still unclear which leads to better outcomes. INSPIRE is designed to answer that question by carefully comparing both approaches when doctors don’t already have a strong preference. For ICU and ECMO survivors, this research matters because intubation is often the first step in a long critical illness journey. Understanding which method best protects oxygen levels, comfort, safety, and long-term recovery can help improve ICU care, reduce traumatic experiences, and shape better outcomes for future patients facing life-saving mechanical ventilation.