Since Cuthbertson’s 1- 2 finding six decades ago that severe trauma patients had greatly increased urinary urea excretion and an accelerated net nitrogen loss from the body, surgeons have tried to further understand the nature of this net nitrogen loss. Many attempts have been made to reverse it, with an expectation for earlier recovery and reduced clinical complications. With the advancement of intensive care and emergency medicine, specifically modern cardiovascular/respiratory support, improved fluid resuscitation, and antibiotics, many acute severely traumatized patients are now able to overcome the initial insult of the injury, and enter a prolonged period of further treatment to battle for survival and recovery.