Abstract
TYPE: Late Breaking Abstract TOPIC: Critical Care PURPOSE: The aim of the current study was to evaluate the effects of donepezil or medroxyprogesterone compared to the placebo in improvement in respiratory status and weaning facilitation in critically ill adult patients receiving mechanical ventilation METHODS: Patients were randomized to receive 5mg donepezil, 5mg medroxyprogesterone, or placebo twice a day until weaning. The primary endpoints were weaning duration and duration of invasive MV. Secondary endpoints included rate of successful weaning, changes in ABG parameters, GCS, SOFA score, hemoglobin, ICU mortality, and duration of ICU stay. RESULTS: Of 78 studied patients who were randomized, 59 weaned successfully. 87% patients in donepezil and 88.5% patients in medroxyprogesterone groups were successfully weaned compared to 66.7% patients in the placebo group. However, this difference was not statistically significant (P-Value=0.111). Changes in pH, mean duration of intubation, and weaning duration were statistically different in donepezil compared with the control group (P-value < 0.05). No significant difference in ABG, Hgb, GCS and SOFA score, and duration of intubation were seen in the medroxyprogesterone group, but weaning duration was significantly reduced to 1.429 days compared with the control group (P-Value =0.038). CONCLUSIONS: Medroxyprogesterone and donepezil could be effective in the facilitation of weaning from MV. Our results in the hospital setting show that pH, mean intubation and weaning duration were the main endpoints during weaning that could be valuable predictors for a positive response to these interventions. However, the effect size of this finding has had uncertain clinical importance. CLINICAL IMPLICATIONS: Donepezil and medroxyprogesterone effects on weaning in adult patients receiving invasive mechanical ventilation DISCLOSURE: Nothing to declare. KEYWORD: Weaning, Donepezil, Medroxyprogesterone
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