Late-Stage Tournament ICM Pressure with a Medium Stack

You’re deep in a high-stakes tournament with 20 players remaining. You have a medium stack, around 20 big blinds, and the blinds are escalating. The table is 9-handed, and players are more cautious due to the increasing bubble pressure. You are faced with a decision to either call a large shove or fold a pocket pair. There are a few big stacks at the table, and you know they are likely to put pressure on smaller stacks.
How do you balance chip preservation versus chip accumulation in this stage of the tournament?
What factors determine whether you call or fold with a medium pocket pair?
How do you adjust for the influence of ICM pressure in this situation?
When should you be more aggressive or more passive with your medium stack during tournament bubbles?