Efficacy And Safety Of Inhaled Nitric Oxide In Pediatric Cardiac Surgery: A Systematic Review And Meta-Analysis AHA Conference Repository

American Heart Association

Final ID: Sa4138

Efficacy And Safety Of Inhaled Nitric Oxide In Pediatric Cardiac Surgery: A Systematic Review And Meta-Analysis

Abstract Body (Do not enter title and authors here):
Background: Congenital heart diseases affect one in every 100 live births. Surgical intervention is necessary for almost half of these cases, with a significant proportion requiring surgery within the first year after birth. This meta-analysis aims to evaluate the efficacy and safety of inhaled nitric oxide (iNO), selective pulmonary vasodilator, particularly its impact on perioperative clinical outcomes such as low cardiac output syndrome (LCOS), duration of mechanical ventilation, blood and fresh frozen plasma (FFP) transfusion, ICU stay, and hospital stay.
Methods: We conducted a comprehensive search of PubMed, Scopus, WOS, and Cochrane databases for relevant studies from inception to April 1, 2024. We included randomized controlled trials (RCTs) comparing iNO with placebo or standard care in pediatric patients undergoing cardiopulmonary bypass. Data extraction and quality assessment were performed according to PRISMA guidelines and Cochrane's risk of bias tool. Mean differences (MD) and their 95% confidence intervals (CI) were calculated using OpenMeta [Analyst].
Results: We included six RCTs in our meta-analysis. Our analysis showed that iNO significantly reduced the duration of mechanical ventilation (MD = -5.733, 95% CI [-10.494; -0.972]). However, no significant differences were observed between the iNO group and the control group for hospital stay, ICU stay, or incidence of LCOS. Safety outcomes showed no significant differences in blood or platelet transfusion rates, though iNO was associated with statistically significant lower FFP transfusion (MD = -5.199, 95% CI [-8.032; -2.366]).
Conclusion: our review and meta-analysis highlights the potential benefits of iNO in reducing ventilation time and FFP transfusion in pediatric patients undergoing cardiac surger, while also emphasizing the need for further research to conclusively determine its impact on other clinical outcomes and safety parameters.

Ramadan, Abdelraouf ( Faculty of Medicine Cairo universit , Cairo , Congo )
Nassar, Sameh ( West Virginia University , Morgantown , West Virginia , United States )
Elrosasy, Amr ( Faculty of Medicine Cairo universit , Cairo , Congo )
Ali, Ahmed ( Faculty of Medicine, Merit University , Sohag , Egypt )
Mahmoud, Nour-aldeen ( Faculty of Medicine Cairo universit , Cairo , Congo )
Ayman, Hassan ( Faculty of Medicine Cairo universit , Cairo , Congo )
Kamel, Menna ( Faculty of Medicine Cairo universit , Cairo , Congo )
Abd Al-azim, Hadeer ( Faculty of Medicine Cairo universit , Cairo , Congo )
Chamay, Salomon ( SBH Health System , The Bronx , New York , United States )
Ghimire, Manoj ( St Barnabas Hospital , Bronx , New York , United States )

Author Disclosures:

Abdelraouf Ramadan:

No Answer

Sameh Nassar: