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Cardiopulmonary bypass (CPB) utilized for cardiac surgeries has been associated with significant mortality and adverse outcomes. The benefits of incorporating nitric oxide (NO) into the CPB circuit have been reported in terms of reduced inflammation, enhanced dynamic circulation, oxygenation, and end-organ function. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of inhaled NO introduced to the CPB circuit among pediatric patients undergoing various cardiac surgeries.