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Even though those exact words were not then used, the terms "energy crisis" and "conservation of resources" occupied the attention of surgeons long before the Middle East War, the Arab oil embargo, offshore drilling, and the Alaskan pipeline. The wasted, debilitated patient with a resectable neoplasm, the malabsorbing, toxic sufferer with regional enteritis receiving large doses of steroids, the massively burned patient, and the postoperative one with peritonitis and a small bowel fistula are all threatened by the energy requirements of the metabolic pool. Systemic metabolic needs in such persons are often increased and so erode lean body mass or muscle. Failure of the skeletal muscle system due to metabolic depletion is as fatal, if not as dramatic or evident, as cardiac, hepatic, renal, or central nervous system failure. It results in the inability to breathe adequately, to cough, to clear secretions, to maintain alveolar inflation, and to move about
BAUE AE. The Energy Crisis in Surgical Patients. Arch Surg. 1974;109(3):349-350. doi:10.1001/archsurg.1974.01360030001001