Peripheral neuropathy and neuromuscular blockade presenting as prolonged respiratory paralysis following critical illness

Abstract

We report two patients who following critical illness presented with generalised paralysis associated with persistent failure to breathe. Both patients eventually recovered and were weaned from the ventilator. The cause of the paralysis was an unusual peripheral neuropathy in the first patient and persistent neuromuscular blockade secondary to vecuronium in the second. It is important to consider a reversible, possibly even iatrogenic, cause of this type of complication.