We report here the case of an infant who developed life-threatening rigid-chest syndrome after receiving an accidental overdose of methadone. The child responded to narcotic reversal. Pediatric physicians should be aware of this possible complication.
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Case report: Intrapulmonary tidal volumes in a preterm infant with chest wall rigidity.
Front Pediatr
August 2022
Newborn Research, Department of Neonatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.
Background: Chest wall rigidity is a known side effect of fentanyl use, which is why fentanyl is usually combined with a muscle relaxant such as mivacurium. Verifying endotracheal intubation is difficult in case of a rigid chest wall.
Case Presentation: We present the case of a preterm infant (29 completed weeks gestation, birth weight 1,150 g) with a prolonged chest wall rigidity after fentanyl administration for intubation despite adequate doses of mivacurium.
Fentanyl-Induced Rigid Chest Syndrome in Critically Ill Patients.
J Intensive Care Med
February 2023
8511Lexington Medical Center, West Columbia, SC, USA.
Background: Opioid induced chest wall rigidity was first described in the early 1950s during surgical anesthesia and has often been referred to as fentanyl induced rigid chest syndrome (FIRCS). It has most commonly been described in the setting of procedural sedation and bronchoscopy, characterized by pronounced abdominal and thoracic rigidity, asynchronous ventilation, and respiratory failure. FIRCS has been infrequently described in the setting of continuous analgesia in critically ill adult patients.
View Article and Find Full Text PDFMethadone-induced rigid-chest syndrome after substantial overdose.
Pediatrics
July 2010
Pediatric Critical Care, St John's Mercy Children's Hospital, Creve Coeur, MO 63141, USA.
We report here the case of an infant who developed life-threatening rigid-chest syndrome after receiving an accidental overdose of methadone. The child responded to narcotic reversal. Pediatric physicians should be aware of this possible complication.
View Article and Find Full Text PDFTherapy of hypoventilation.
Semin Respir Crit Care Med
June 2009
University of Pittsburgh Medical Center, Montefiore University Hospital, Pennsylvania, 15213, USA.
Hypoventilation can present as the primary manifestation or as a part of the clinical spectrum in a variety of diseases. It often goes unrecognized by clinicians and health care providers, especially if the presentation is subacute. If untreated, it is associated with increased morbidity and mortality.
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