The mechanisms that underlie multiple organ dysfunction syndrome (MODS) are not known [2] , although several have been proposed, including overwhelming infection or immune response, immune paralysis, occult oxygen debt and mitochondrial dysfunction [3] [4] [5] . Although these potential mechanisms have features in common, it is not clear whether MODS is a final common pathway or when it is engaged. The innate and adaptive immune systems, coagulation, and hormonal and neuronal signalling are undoubtedly involved and are all connected. For example, the hypoxic response is linked to innate immunity and inflammation by the transcription factor nuclear factor-κB (NF-κB) [6] . It is no coincidence that the few interventions that appear to be of benefit, although this is still under debate, have pleiotropic mechanisms of action [7] [8] [9] . Thus, it seems reasonable to study the intersections between and within cellular and molecular systems to elucidate the interactions and to develop therapeutic options.