Fentanyl-Induced Chest Wall Rigidity Causing Recurrent Ventilator Dyssynchrony in the Intensive Care Unit: A Case Report

Abstract

While fentanyl remains a valuable for pain management in the ICU, this case highlights fentanyl-induced chest wall rigidity as a reversible cause of refractory ventilator dyssynchrony that should be suspected when sudden reductions in lung compliance and ineffective ventilation occur without identifiable pulmonary or mechanical causes, particularly in patients receiving continuous opioid infusions. Early recognition and opioid adjustment restore effective ventilation and prevent unnecessary diagnostic or therapeutic interventions.