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Critical illness is mostly defined as a life-threatening process affecting numerous systems of the body. Unfortunately, despite all implemented strategies, critical illness could be associated with significant morbidity or mortality. Although the early signs of critical illness are commonly neglected, a period of physiological weakening usually heralds the situation. Very clinical staff and even visitors play a pivotal role throughout appropriate assessment and intervention steps. Muscle weakness in the critically-ill, as a major complication in ICUs, is associated with increased length of ICU stay and mortality. Numerous variables could directly contribute to the muscle weakness of the critically-ill patients following Neuromuscular Blocking Drugs (NMBDs) administration including the dosage, administration method (intermittent vs. bolus) and duration and also the approaches used for monitoring neuromuscular block depth. Based on the recent guidelines NMBDs are recommend to be used in critically-ill patients only when absolutely necessary, the depth of muscle paralysis be monitored to avoid overdosing and metabolite accumulation, and that drug administration be curtailed periodically to allow interruption of sustained NMBDs effect.
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