{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T15:39:43Z","timestamp":1793720383675,"version":"4.6.1"},"reference-count":146,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"PROPESP-UFPA"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Patients undergoing coronary revascularization with extracorporeal circulation or cardiopulmonary bypass (CPB) may develop several biochemical changes in the microcirculation that lead to a systemic inflammatory response. Surgical incision, post-CPB reperfusion injury and blood contact with non-endothelial membranes can activate inflammatory signaling pathways that lead to the production and activation of inflammatory cells, with cytokine production and oxidative stress. This inflammatory storm can cause damage to vital organs, especially the heart, and thus lead to complications in the postoperative period. In addition to the organic pathophysiology during and after the period of exposure to extracorporeal circulation, this review addresses new perspectives for intraoperative treatment and management that may lead to a reduction in this inflammatory storm and thereby improve the prognosis and possibly reduce the mortality of these patients.<\/jats:p>","DOI":"10.3390\/jpm13101506","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T09:55:06Z","timestamp":1697622906000},"page":"1506","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Biochemical Changes in Cardiopulmonary Bypass in Cardiac Surgery: New Insights"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5095-0168","authenticated-orcid":false,"given":"Luan Oliveira","family":"Ferreira","sequence":"first","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"},{"name":"Laboratory of Experimental Neuropathology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria Winkler","family":"Vasconcelos","sequence":"additional","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janielle de Sousa","family":"Lima","sequence":"additional","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime Rodrigues","family":"Vieira Neto","sequence":"additional","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovana Escribano","family":"da Costa","sequence":"additional","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordana de Castro","family":"Esteves","sequence":"additional","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sallatiel Cabral","family":"de Sousa","sequence":"additional","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan Almeida","family":"Moura","sequence":"additional","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe Ruda Silva","family":"Santos","sequence":"additional","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Monteiro","family":"Leit\u00e3o Filho","sequence":"additional","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University Hospital, Federal University of Par\u00e1, Bel\u00e9m 66073-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus Ramos","family":"Prot\u00e1sio","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein\u2014HIAE, S\u00e3o Paulo 05652-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pollyana Sousa","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Anesthesiology, Hospital Cl\u00ednicas Gaspar Vianna, Bel\u00e9m 66083-106, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udio Jos\u00e9 da Silva","family":"Lemos","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Anesthesiology, Hospital Cl\u00ednicas Gaspar Vianna, Bel\u00e9m 66083-106, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina Dias","family":"Resende","sequence":"additional","affiliation":[{"name":"Residency Program in Anesthesiology, Jo\u00e3o de Barros Barreto University 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