SETPOINT2 is a research study intended to determine the best timing for temporary tracheostomy in patients with severe stroke who require mechanical ventilation. Tracheostomy is a surgical breathing tube that enters the airway through the front of the neck, and is connected to the mechanical ventilator to assist with breathing. This tube replaces the breathing tube that goes through the mouth and vocal cords. The timing of this common procedure may affect the amount of sedating medications that are required, and could affect how the brain recovers and the body’s ability to return to pre-stroke activities. Preliminary studies suggest it could be beneficial to perform a reversible tracheostomy procedure earlier than is usually done after severe stroke (within the first 5 days) as opposed to delaying more than 10 days before performing the procedure. Setpoint 2