The role of nitric oxide in nephroprotection during surgical correction of congenital heart disease in children (literature review)

Introduction . The need to develop effective methods of renal protection during cardiac surgical interventions is dictated by the progressive increase of acute kidney injury (CS-AKI) in children, which is associated with immaturity of renal function and damaging factors of cardiopulmonary bypass (CPB): activation of systemic inflammation response, hypothermia, hemodilution, hemolysis, transfusion of donor blood components, hypoxia/hyperoxia. CS-AKI in this population results in worsening of both early and long-term patient prognosis. However, there is no universally accepted strategy for nephroprotection in pediatric cardiac surgical patients. The objective was to analyze existing data on the efficacy of nitric oxide as renal organoprotection in the pediatric cardiac surgery population for 2019–2024. Materials and Methods . The analysis was performed using domestic and international biomedical databases using the keywords: nitric oxide, nitric oxide inhalation, nephroprotection, artificial circulation, cardiac surgery, children. Results. The review presents current information on intraoperative use of nitric oxide during cardiac surgery under artificial circulation and its effect on further development of acute kidney injury. Conclusion . Nitric oxide is a promising method of nephroprotection in cardiac surgery of different age groups using artificial circulation, which is confirmed by clinical studies, as well as by the results of serologic and histologic sampling of animal models. The data on the use in pediatric patient group is insufficient and requires further studies.