NITRIC OXIDE IN PEDIATRIC CARDIAC SURGERY: CURRENT PARADIGM AND POSSIBILITIES FOR EXPANDING INDICATIONS
https://doi.org/10.17802/2306-1278-2026-15-4-242-254
Abstract
Highlights
The presented publication highlights the pathophysiological aspects of multiple organ failure syndrome associated with cardiac surgical correction of congenital heart diseases in conditions of artificial circulation, as well as analyzes current indications and features of the use of inhaled nitric oxide in children.
Abstract
Congenital heart diseases remain the leading cause of infant mortality. Multiple organ failure, which develops as a result of ischemic reperfusion injury and systemic inflammation during artificial blood circulation, determines the unfavorable outcomes of operations. The key link in these processes is the deficiency of nitric oxide (NO). Traditionally, inhaled NO is used for pulmonary hypertension and hypoxemia in newborns. However, its pleiotropic effects – vasodilation, inhibition of platelet aggregation, stabilization of the endothelium and antioxidant effect – justify the expansion of indications. This review analyzes the current aspects of the use of NO in pediatric cardiac surgery: the physiological basis, current indications, as well as the causes of treatment failures. Special attention is paid to new directions – intraoperative organoprotection with artificial blood circulation. Despite the inconsistency of the data and the lack of uniform recommendations, the accumulated evidence points to the prospects of including nitric oxide in the protocols of anesthetic aids to improve outcomes in children with congenital heart diseases.
About the Authors
Anastasia S. Tsarkova
Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”
Russian Federation
Russian Federation
anesthesiologist-resuscitator, Intensive Care unit of Cardiac Surgery Department № 2, Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”, Tomsk, Russian Federation
Oleg A. Egunov
Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”
Russian Federation
Russian Federation
PhD, Cardiovascular Surgeon, Head of Cardiac Surgery Department No. 2, Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”, Tomsk, Russian Federation
Yuri K. Podoksenov
Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”
Russian Federation
Russian Federation
PhD, MD, Senior Researcher at the Laboratory of Critical Condition Medicine, Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”, Tomsk, Russian Federation
Nikolay O. Kamenshchikov
Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”;
Siberian State Medical University
Russian Federation
Russian Federation
PhD, MD, Head of the Laboratory of Critical Condition Medicine, Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”, Tomsk, Russian Federation; Associate Professor, Department of Anesthesiology, Resuscitation and Intensive Care, Siberian State Medical University, Tomsk, Russian Federation
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Review
For citations:
Tsarkova A.S., Egunov O.A., Podoksenov Yu.K., Kamenshchikov N.O. NITRIC OXIDE IN PEDIATRIC CARDIAC SURGERY: CURRENT PARADIGM AND POSSIBILITIES FOR EXPANDING INDICATIONS. Complex Issues of Cardiovascular Diseases. 2026;15(4):242-254. (In Russ.) https://doi.org/10.17802/2306-1278-2026-15-4-242-254
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