Remifentanil Procedural Sedation in ICU for EGD in Bleeding Patient with IABP

44F in DKA with newly diagnosed DM (A1c >14), bilateral pleural effusions, bilateral DVTs, nonischemic cardiomyopathy (LHC showed non obstructive CAD, TTE LVEF severely reduced 10-15%, RV moderate to severe systolic dysfunction, apical septal thrombus). An IABP and R chest tubes were inserted, and anticoagulation was initiated. She began passing melanotic stools on anticoagulation with Hgb nadir 7.6 from 12.6. Patient had a MP IV airway and risk factors for OSA. She was scheduled for EGD in ICU.