Meta-analysis of impacts of inhaled nitric oxide on postoperative renal injury and hemorrhage.

Objective · To evaluate the effects of inhaled nitric oxide on renal injury and hemorrhage after surgery. Methods · China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), WanFang Data, PubMed, Embase, Web of Science and The Cochrane Library were searched systematically from the establishment of each database to March 26, 2021. "外科手术" and "一氧化氮" were used as Chinese keywords for retrieval. Correspondingly, the "nitric oxide" "surgical procedures, operative" "cardiac surgical procedures" "cardiac surgery" and "transplantation" were used as subject words and free words for searching. The literatures were screened according to the pre-established inclusion and exclusion criteria. Meta-analysis was performed by using RevMan 5.3. The study end points were the incidences of renal injury and hemorrhage. Results · Seven literatures were included for analysis, with a total of 689 surgical patients. Of them, 337 received nitric oxide treatment and 352 received placebo treatment. Compared with the control group, patients treated with nitric oxide demonstrated a statistically difference in reducing the incidence of postoperative renal injury (RR= 0.75, 95%CI 0.61-0.92, P=0.005). There was no significant difference in the incidence of hemorrhage (RR=0.79, 95%CI 0.22-2.83, P=0.710) between the two groups. Conclusion · Application of nitric oxide after surgery does not increase the risks of renal injury and hemorrhage. In contrast, the use of nitric oxide in cardiopulmonary bypass might protect renal function. [ABSTRACT FROM AUTHOR]