الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
For critically ill children admitted to the pediatric intensive care unit (PICU), mechanical ventilation is a standard procedure. Although mechanical ventilation has several advantages, it also has drawbacks. Unnecessary prolonged mechanical ventilation has been related to an elevated risk of airway trauma and inflammation. Extubation failure was defined by the necessity for new intubation and return to invasive mechanical ventilation within 48 hours after endotracheal tube removal. The extubation failure rate in pediatrics was 2-20%, depending on PICU service and patient characteristics. Both premature and delayed extubation increase morbidity and mortality as well as costs.
The development of a complex system of neural injury-induced stimuli that triggers the central nervous system resulting in alterations at the hypothalamic-anterior pituitary axes, these include the adrenal gland (increased cortisol secretion), the somatotrophic (increased growth hormone secretion), the thyrotrophic [decreased triiodothyronine (T3) and increased reversed T3 (rT3) secretion]. Multiple studies have demonstrated strong associations between the degree of thyroid disturbances and the severity of illness in adults. The data in pediatrics in this field are sparse relative to that in the adult population.