Evaluation of effects of oral medroxyprogesterone and donepezil in improvement of respiratory status and facilitation in weaning of mechanical ventilation in patients undergoing mechanical ventilation in ICUs of Shahid Dr. Rahnemoon Yazd

Inclusion criteria:

Mechanical ventilation through endotracheal tube for at least 24 hours oxygen saturation greater than 90% FIO2 less than 50% PEEP less than 8 cm water hemodynamic stability over the past 12 hours sedation withdrawal or sedation reduction Over the past 48 hours neurological status stabilized with Ramsay's score less than 5 temperature between 36 and 39 degrees

Exclusion criteria:

Pregnancy or lactation under 18 years of age tracheostomy hepatic encephalopathy cerebral edema acute hydrocephalus myasthenia gravis Acute polyneuropathy lack of decision to discontinue respiratory support prolonged cardiac arrest with poor neurologic prognosis coincident extubation with day one acute right ventricular failure renal failure plasma urea exceeding (25 mol / L), Plasma creatinine greater than (180 mol / min) or creatinine clearance less than 30 ml / min, or more than 25% increase in creatinine over the past 24 hours contrast injection over the past six hours Serum sodium level greater than (150 m Eq) / L serum potassium level less than 3.5 (m Eq) / L metabolic alkalosis with arterial pH greater than 7.5 need for sedation or unconsciousness concurrent administration of drugs Potential respiratory stimulants such as doxapram and medroxyprogesterone hypothyroidism Known allergy to donepezil or medroxy progesterone

Target sample size: 45