Journal of Pharmacovigilance

Can Donepezil facilitate weaning from mechanical ventilation in difficult to wean patients? An interventional pilot study

Conference Series LLC Joint International Event on 7^th Pharmacovigilance & Pharmaceutical Industry

August 22-24, 2016 Vienna, Austria

Kamran Fazel

Bagiatalla University of Medical Sciences, Iran

Posters & Accepted Abstracts: J Pharmacovigil

Abstract:

Management of difficult to wean patients is a dilemma for health care system. Recent studies demonstrated efficacy of Donepezil to counteract respiratory depression in sleep apnea. However, pharmaceutical interventions with Donepezil to facilitate weaning have not been tested so far. In this non-randomized interventional clinical study, we evaluated the efficacy of using Donepezil on weaning course in difficult to wean (eligible) patients. Eligible patients with prior inappropriately depressed respiratory responses were included from two referral ICUs in Iran. Other potentially reasons of weaning failure were excluded. Donepezil was started at dose of 10 mg daily for 2�??4 weeks. For the primary outcomes, arterial blood gas (ABG) parameters were also measured before and after intervention. Weaning outcomes of patients were reported as final outcome. Twelve out of 16 studied patients had successful results to facilitate weaning. The mean duration of Donepezil treatment until outcome measurement was 12 days. There were not any significant differences in ABG parameters among patients with successful and failed weaning trial on day of Donepezil initiation. However after intervention, mean of PCO2 and HCO3 decreased in patients with successful weaning trial and mean of PCO2 increased in those with weaning failure. Reduced central respiratory drive was infrequently reason of failed weaning attempts but it must be considered especially in patients with hypercapnia secondary to inefficient gas exchange and slow breathing. The results suggest that,the use of Donepezil can expedite weaning presumably by stimulation of respiratory center and obviate the need to re-intubation in cases of respiratory drive problem in these patients. We suggest decrease PCO2 and HCO3 during Donepezil steady could be valuable predictors for positive response to Donepezil intervention.

Biography :

Kamran Fazel has completed his MD from Isfah an University of Medical Sciences. He completed Postgraduation in Anesthesia and Critical Care Medicine at 2012 from Bagiatalla University of Medical Sciences and has completed fellowship in Critical Care Medicine from Isfahan University School of Medicine at 2014. He has published 5 papers in reputed journals.

Email: kamranfazel_2009@yahoo.com