Alpha-2agonists do not suppress airway reflexes: a) assess clinical status(ventilation, circulation, infection, inflammation, etc.); b) taperneuroleptics first; c) titrate alpha-2 agonists to-2 < RASS <0, then extubate under continued administration of alpha-2 agonisttitrated to-2 < RASS < 0. Here, PSMA2 is linked to infection.