Journal of the American College of Surgeons
-
Resuscitation with Lactated Ringer's solution after hemorrhagic shock in rats has been shown to cause early cellular injury in the lung. We hypothesized that the use of energy substrates, such as ketone bodies, in the resuscitation fluids would protect against this injury. As markers of cellular injury we measured the induction of apoptotic cell death and the expression of Intracellular Adhesion Molecule-1 (ICAM-1). ⋯ Substitution of lactate with ketone bodies in the resuscitation fluid attenuates the expression of cellular injury markers in the lung.
-
The elderly consume up to one third of health care resources and have become a target for cost reduction efforts. This study was performed to evaluate elderly survivors of surgical critical illness using perceived quality of life and activities of daily living as indicators of value of care. ⋯ Although overall functional levels fell, rates of full dependency rose only slightly and perceived quality of life was high in a group of elderly patients surviving surgical intensive care. High hospital and postdischarge mortality should not motivate restriction of care for elderly patients requiring surgical intensive care given their high postillness subjective quality of life measures.