The injury activates an inflammatory response by releasing reactive oxygen species and pro-inflammatory cytokines (TNF-alpha, IL-6, IL-8, IL-1), which leads to increased vascular permeability, leukocyte demargination, and extravasation [23]. Strategies to mitigate the risk associated with intraoperative circulatory arrest times could include optimizing anesthesia management, ensuring efficient surgical techniques, and using adjunctive therapies like ECMO support when necessary. Here, TNF is linked to cardiac arrest.