Previous studies have shown that high-dose corticosteroids or neuromuscular blocking agents (NMBA) [84] may affect diaphragm function [85] . Maes et al. [86] hypothesised that the combination of rocuronium (NMBA) and corticosteroids would result in a further deterioration of diaphragm function in a model of ventilator-induced diaphragm dysfunction (VIDD). They observed that the negative effect of rocuronium infusion with controlled mechanical ventilation was absent with the administration of a high dose of corticosteroid due to inhibition of the calpain and caspase-3 system.