Perspectives on Using Inhaled Nitric Oxide and Its Organ Protection Features in Cardiovascular Surgeries With Cardiopulmonary Bypass: A Systematic Review

Highlights Cardiovascular surgery with cardiopulmonary bypass for congenital heart defects in children is associated with the issue of organ protection that impacts the outcome and subsequent rehabilitation process. The literature review highlights the need to improve cardiopulmonary bypass-associated adverse effects in cardiovascular interventions in different patient populations. Article Pathological effects of cardiopulmonary bypass (CPB), which is necessary for most surgeries in children and adults with congenital heart defects, remains an unresolved issue. The functional immaturity of the circulatory system and endogenous mechanisms of organ protection in children necessitates intraoperative protection of the organs affected by CPB. The severity of the effects of extracorporeal circuits can lead to an increase in comorbidity and mortality in patients who have undergone CPB. The relevance of the study lies in the fact that most organ protection strategies adopted in adults are inapplicable in children. The search for Russian and English publications (up to 7 years old) was performed using the following databases: Web of Science, PubMed, E-library. The keywords for the search were: nitric oxide, cardiopulmonary bypass, congenital heart defects, organ protection. Literature analysis results revealed the potential for further research on the inhaled nitric oxide for organ protection during cardiac surgery, and the feasibility of its perioperative administration. The nitric oxide is a promising method of organ protection in cardiac surgery with CPB. Moreover, scientific data highlight the importance of the organ protection during CPB in order to ensure successful outcome of the intervention. However, further research on inhaled nitric oxide effects is necessary.