In our study, prolonged CPB in adult sheep led to significantly higher lactate levels (Fig. 6A, B), metabolic acidosis, and transient anemia, suggesting heightened systemic inflammatory responses Previous studies have also associated prolonged CPB with the accumulation of inflammatory mediators, such as cytokines and acute-phase proteins, exacerbating tissue damage and impairing healing processes [3, 56]. Here, DDAH2 is linked to anemia.