Treatment of sepsis includes fluid administration, antibiotic therapy, and supporting multiple organ dysfunction but lacks definitive treatment strategies. There are several reasons for the absence of efficacious therapy despite decades of study. The first is the gap between small animal research studies and implementation into human trials. While small animal studies are critical to developing therapeutic strategies and are phylogenetically respectful, it is equally important that these therapies be tested in a large animal model with a similar temporal and pathophysiologic evolution of human sepsis, and response to treatment. It is also vital that the animals are treated as though they are in an intensive care unit to replicate standard of care management as closely as possible. Therapies that have not successfully modified sepsis-related outcomes include those that attempt to blunt the entire immune response (e.g. steroids) but do not differentiate the helpful inflammation from the harmful, exaggerated inflammation, thereby eliminating nature’s first line of defense. Finally, many treatments use a ‘one-size-fits all’ approach which may demonstrate benefit when averaged across an entire population but do not treat the individual in a patient-specific approach.

The critical care laboratory projects are all geared toward modifying sepsis and lung injury in a multi-pronged approach by first enhancing the understanding of harmful sepsis pathways, then addressing them in a targeted manner, while also determining means of supporting the secondarily injured lung.