Approximately 33% of all adult patients admitted to an intensive care unit require mechanical ventilation (MV); therefore, over 300,000 adult patients receive MV annually in the United States. Failure to wean patients from MV is an important clinical problem because increased time on the ventilator increases ventilator-associated complications and mortality. The Respiratory Muscle Research Laboratory, co-directed by Drs. Sanford Levine and Sunil Singhal, utilizes a translational research approach to elucidate the cellular and molecular remodeling of the respiratory muscles that are associated with pulmonary diseases and disorders (e.g., COPD, patients undergoing mechanical ventilation). Our approach is to elucidate this remodeling by utilizing state of the art molecular biological techniques on respiratory muscle biopsies obtained from patients whose disease states have been fully characterized by clinical, radiological and laboratory studies. Within the past several years, findings by this lab have altered the therapeutic paradigms for patients with severe COPD as well as for patients undergoing mechanical ventilation for prolonged periods of time.