{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T11:01:57Z","timestamp":1793444517642,"version":"4.5.0"},"reference-count":198,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"scientific project approved by the Croatian Science Foundation to Vlatka Soto\u0161ek","award":["IPS-2023-02-9650"],"award-info":[{"award-number":["IPS-2023-02-9650"]}]},{"name":"scientific project approved by the Croatian Science Foundation to Vlatka Soto\u0161ek","award":["uniri-iskusni-biomed-23-88-3035"],"award-info":[{"award-number":["uniri-iskusni-biomed-23-88-3035"]}]},{"name":"scientific project approved by the Croatian Science Foundation to Vlatka Soto\u0161ek","award":["ARIS-J3-50120"],"award-info":[{"award-number":["ARIS-J3-50120"]}]},{"name":"University of Rijeka to Lara Bati\u010di\u0107","award":["IPS-2023-02-9650"],"award-info":[{"award-number":["IPS-2023-02-9650"]}]},{"name":"University of Rijeka to Lara Bati\u010di\u0107","award":["uniri-iskusni-biomed-23-88-3035"],"award-info":[{"award-number":["uniri-iskusni-biomed-23-88-3035"]}]},{"name":"University of Rijeka to Lara Bati\u010di\u0107","award":["ARIS-J3-50120"],"award-info":[{"award-number":["ARIS-J3-50120"]}]},{"name":"scientific project approved by Slovenian Research and Innovation Agency to Marko Zdravkovi\u0107 and Maja \u0160o\u0161tari\u010d","award":["IPS-2023-02-9650"],"award-info":[{"award-number":["IPS-2023-02-9650"]}]},{"name":"scientific project approved by Slovenian Research and Innovation Agency to Marko Zdravkovi\u0107 and Maja \u0160o\u0161tari\u010d","award":["uniri-iskusni-biomed-23-88-3035"],"award-info":[{"award-number":["uniri-iskusni-biomed-23-88-3035"]}]},{"name":"scientific project approved by Slovenian Research and Innovation Agency to Marko Zdravkovi\u0107 and Maja \u0160o\u0161tari\u010d","award":["ARIS-J3-50120"],"award-info":[{"award-number":["ARIS-J3-50120"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Since its introduction, the number of heart surgeries has risen continuously. It is a high-risk procedure, usually involving cardiopulmonary bypass, which is associated with an inflammatory reaction that can lead to perioperative and postoperative organ dysfunction. The extent of complications following cardiac surgery has been the focus of interest for several years because of their impact on patient outcomes. Recently, numerous scientific efforts have been made to uncover the complex mechanisms of interaction between inflammation, oxidative stress, and endothelial dysfunction that occur after cardiac surgery. Numerous factors, such as surgical and anesthetic techniques, hypervolemia and hypovolemia, hypothermia, and various drugs used during cardiac surgery trigger the development of systemic inflammatory response and the release of oxidative species. They affect the endothelium, especially endothelial glycocalyx (EG), a thin surface endothelial layer responsible for vascular hemostasis, its permeability and the interaction between leukocytes and endothelium. This review highlights the current knowledge of the molecular mechanisms involved in endothelial dysfunction, particularly in the degradation of EG. In addition, the major inflammatory events and oxidative stress responses that occur in cardiac surgery, their interaction with EG, and the clinical implications of these events have been summarized and discussed in detail. A better understanding of the complex molecular mechanisms underlying cardiac surgery, leading to endothelial dysfunction, is needed to improve patient management during and after surgery and to develop effective strategies to prevent adverse outcomes that complicate recovery.<\/jats:p>","DOI":"10.3390\/ijms252010891","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T07:53:05Z","timestamp":1728546785000},"page":"10891","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["The Crucial Triad: Endothelial Glycocalyx, Oxidative Stress, and Inflammation in Cardiac Surgery\u2014Exploring the Molecular Connections"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2591-7267","authenticated-orcid":false,"given":"Bo\u017eena","family":"\u0106urko-Cofek","sequence":"first","affiliation":[{"name":"Department of Physiology, Immunology and Pathophysiology, Faculty of Medicine, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matej","family":"Jenko","sequence":"additional","affiliation":[{"name":"Clinical Department of Anaesthesiology and Surgical Intensive Care, University Medical Centre, Zaloska 7, 1000 Ljubljana, Slovenia"},{"name":"Medical Faculty, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4939-0380","authenticated-orcid":false,"given":"Gordana","family":"Taleska Stupica","sequence":"additional","affiliation":[{"name":"Clinical Department of Anaesthesiology and Surgical Intensive Care, University Medical Centre, Zaloska 7, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2837-4157","authenticated-orcid":false,"given":"Lara","family":"Bati\u010di\u0107","sequence":"additional","affiliation":[{"name":"Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antea","family":"Krsek","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Batinac","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences I, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 2, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Ljuba\u010dev","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0033-7071","authenticated-orcid":false,"given":"Marko","family":"Zdravkovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and Pain Management, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danijel","family":"Kne\u017eevi\u0107","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Reanimatology, Emergency and Intensive Care Medicine, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3717-5782","authenticated-orcid":false,"given":"Maja","family":"\u0160o\u0161tari\u010d","sequence":"additional","affiliation":[{"name":"Clinical Department of Anaesthesiology and Surgical Intensive Care, University Medical Centre, Zaloska 7, 1000 Ljubljana, Slovenia"},{"name":"Medical Faculty, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-5364","authenticated-orcid":false,"given":"Vlatka","family":"Soto\u0161ek","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences I, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 2, 51000 Rijeka, Croatia"},{"name":"Department of Anesthesiology, Reanimatology, Emergency and Intensive Care Medicine, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"ref_1","first-page":"171","article-title":"Application of a mechanical heart and lung apparatus to cardiac surgery","volume":"37","author":"Gibbon","year":"1954","journal-title":"Minn. 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