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Aging-associated arterial stiffening further disrupts flow patterns, potentially exacerbating OS and promoting EC dysfunction [11, 12, 193, 199]

Several factors can deplete hepatic glutathione stores: Chronic alcohol consumption that overwhelms detoxification pathways Acetaminophen overdose or prolonged use of hepatotoxic medications Metabolic dysfunction associated with obesity and insulin resistance Viral hepatitis and chronic inflammatory conditions Age-related decline in antioxidant enzyme production Understanding these mechanisms helps explain why both glutathione and NAC have become subjects of intense clinical research for liver support and repair

Successful completion of this aim will establish a safety profile for ketone use in the ICU, which is essential before adopting this novel therapy for critically ill patients