We are evaluating biomarkers in patients with severe infections that lead to shock and lung dysfunction. Samples are being analyzed in collaboration with collaborators at the University of Tennessee Memphis who have conducted a trial prospectively evaluatng the effects of corticosteroids on outcome from septic shock or severe respiratory failure. Our goals are to evaluate biomarkers at the time of study entry and during the course of the illness to determine if there are molecules that will help characterize the patients who are likely to have a beneficial response from corticosteroid therapy. Similarly, whether biomarkers can help define the high risk patient who will benefit from anti-inflammatory therapy.