This proposal represents the consolidation of two currently funded research centers into a single center oriented toward evaluation and modification of the response of physiologic systems to mechanical and thermal injury. It consists of a Core which supplies administrative and laboratory support as well as clinical research area with patient access and a reliable patient data base for 17 interrelated projects. The response to injury and defense against infection is investigated by projects involving antibiotic prophylaxis in burns and following abdominal trauma, immune response in thermal injury and smoke inhalation and small vessel response to injury. The hemeostatic system is evaluated by projects oriented toward understanding regulation of energy and fuels following injury, membrance transport in septic shock, interstitial changes in hypovolemic shock, and red cell oxygen transport in septic patients. Investigations of the pulmonary system include exploration of the pathophysiology of ARDS using the six inert gas technique, indepth study of smoke inhalation injury in the animal model, and evaluation of the changes in pulmonary function induced by injury and treatment in patients, as well as studies of the distribution of mechanical ventilation. Evaluation of treatment modalities include the development of photocoagulation scalpel, the effects of massive transfusion on physiologic function, the development of a non-invasive index for cardiac performance, exploration of algorithmic control of intravenous fluid therapy, and the evaluation of the effect of pre-hospital care on the outcome of traumatized patients.