The metabolic response to trauma has been an area of intense clinical research since Studley's identification of an increase in postoperative mortality and morbidity in patients with preoperative weight loss. Consequently, considerable efforts have been made to modify the response, including the use of nutritional, pharmacologic and environmental manipulations, and have met with varying degrees of success. The concept of using intraoperative hypothermia to reduce the "stress response to surgery" was first postulated in the 1950s but there has been little evidence to support this premise. Recently, however, a reduction in "post-traumatic proteolysis" following open-heart surgery, using a combination of moderate hypothermia (2
