الفهرس 
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Abstract
During critical illness, changes in circulating thyroid hormonal levels are a common phenomenon. These alterations are correlated with the severity and outcome of patients in intensive care unit. Thyroid hormones stay a key role in the maintenance of the body growth.Modulating metabolism and the immune system. It was found that alteration in the level of these have great effect on the outcome of patients in addition to duration of mechanical ventilation and difficulty in weaning from the mechanical ventilationThe current study aimed to clarify role of thyroid dysfunction on difficulty weaning from mechanical ventilation. The study enrolled 50 patients were admitted to intensive care unit and all of them received mechanical ventilation. It was conducted in period between January 2021 and December 2021.Mean age of enrolled patients was 56.64 ± 16.97years with range between 18 and 90 years. Out of the studied patients; 33 (66%) patient was males and 17 (34%) patient was females. Mean body index was 22.47 ± 3.99 (kg/m2). As raged cause of admission; the most frequent causes were cardiogenic shock (30%) and toxicity (30%) Based on thyroid function, it was found that majority (70%) of patients had normal thyroid status while 15 (30%) patients had euthyroid sick syndrome. Out of those patients; 28 (56%) patients had successful Summary and Conclusion weaning while 22 (44%) patients had difficult weaning. Eighteen (36%) patients were alive while 32 (64%) patients were deteriorated and died. It was found that patients with euthyroid sick syndrome had longer duration of mechanical ventilation and hospital stay. Also, majority (68.6%) of patients with normal thyroid function had successful weaning while majority (73.3%) of those with ESS had difficult weaning.Patients with difficult weaning had lower level of thyroid hormones and longer hospital stay. It was found that 50% of patients with difficult weaning had euthyroid sick syndrome. Both groups of patients either with euthyroid sick syndrome or normal thyroid status had insignificant differences regarding the overall survival and in hospital mortality where 12 (34.3%) patients of those with normal thyroid status and 6 (40%) patients with ESS were alive.The current study found that died patients had significantly lower free triiodothyronine in comparison to those alive patients. Predictors of difficult weaning among studied patients were diaphragmatic dysfunction and euthyroid sick syndrome.