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Atracurium is a neuromuscular blocking agent that spontaneously degrades by Hoffmann reaction. This study of a prolonged infusion (7 days) in an infant of 6 months shows an increase in infusion rate requirement from 0.7 mg/kg/h after 96 h of infusion to 1.8 mg/kg/h at the 7th day. The plasma laudanosine levels remained relatively constant (977-1,515 ng/ml) and well below the reported potent convulsive levels during the study despite a 3-fold increase in the atracurium requirement. No side effect or accumulation of the drug was observed. The reasons for the increase in atracurium requirement are discussed.

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These results indicate that aprotinin at doses currently used to reduce blood loss has no significant influence on the systemic inflammatory response during moderate hypothermic cardiopulmonary bypass in human subjects, as assessed by the mediators measured in this study.