Comparison of Lormetazepam and Midazolam Used as Sedatives for Patients That Require Intensive Care

Inclusion Criteria: * Mechanically ventilated ICU patients with the need for sedatives to achieve or maintain the intended target-RASS (surgical/ nonsurgical). * Age ≥ 18 years * Patients who are incapable of giving consent at study inclusion: Written informed consent by patient's legal representative or an independent medical consultant, patients give informed consent subsequent if they are capable. * Patients who are able to give informed consent at study inclusion: Written informed consent by patients for planned postoperative prolonged ventilatory support who undergo heart surgery * Consensable patients for inclusion: with necessary intubation with analgosedation Exclusion Criteria: * Any bolus administration of benzodiazepines until 72hrs before inclusion (except from premedication due to anaesthesia). * Continuous administration of benzodiazepines within the last 7 days before start of study drug application * Titration phase: No way that a target RASS between -3 and 0 can be determined by the attending physician * Known drug intolerance or allergy against lormetazepam, midazolam or one of the additional components. * Addictive disorder * Increased intracranial pressure * Acute intoxication with alcohol, analgesics, sedatives, antipsychotics (neuroleptics, anti-depressives, lithium). * Patients with cerebrale Pathology, which changes the controllability of sedation or die consciousness (e.g. patients known mental retardation due to syndromatic disorders or an infantile brain damage) * Patients with a suspected or secured hypoxic brain damage * Patients with intracranial surgery during actual hospital care * Tetraplegic patients * Myasthenia Gravis * Cerebellar or spinal Ataxia * Moribund patients with an expected lifespan of less than 24 hours. * Sickle cell anaemia * Thallassemia * Enzyme related disorders that are associated with a severe decreased activity of UDP-glucoronyltransferase (e.g. M. Crigler- Najjar) * Chronic liver insufficiency CHILD C with MELD Score \> 17 before access to intensive care unit * Diagnosed propofol intolerance/anamnestic propofol infusion Syndrome * Known depression/suicidality * Pregnancy (positive beta-HCG test from urine or positive beta-HCG laboratory test from serum (in anuric patients the serum beta-HCG test is obliged) or lactation * Woman of child-bearing potential who are not using a highly effective contraception (Pearl - Index \<1) until 3 months after study inclusion and during this trial * Referral following an order of official authorities (court order or administrative decision) according to German Drug Law (AMG) §40 (1) 4 * Participation in clinical trials according to the German Drug Law (AMG) 30 days to and during the study * Local staff