Early Metabolic Support as a Potential Solution to Multi-Organ Dysfunction Syndrome (MODS) During Severe Sepsis

Inclusion Criteria: 1. All adult patients 18-years-old or greater 2. Admitted to the adult medical intensive unit (MICU) of MD Anderson Cancer Center 3. Diagnosis of Sepsis within 12 hours of MICU admission defined as: 1) Suspected or documented infection and 2) Acute increase of \>/= 2 SOFA points (a proxy for organ dysfunction) 4. Diagnosis of Septic Shock within 12 hours of MICU admission defined as meeting criteria for sepsis (see inclusion criteria C) in addition to the following: 1) Vasopressor therapy needed to elevate MAP \>/= 65 mmg Hg and 2) Lactate \> 2 mmol/L (18 mg/dL) after adequate fluid resuscitation 5. Sequential Organ Failure Assessment (SOFA) score meeting the following requirements: 1) Cardiovascular SOFA \>/= 2 and 2) Total SOFA score of less than 15 6. Diagnosis of leukemia, lymphoma, or status post stem cell transplantation 7. Patients in septic shock and not able to tolerate enteral nutrition above 70 percent of their daily nutritional caloric intake. Exclusion Criteria: 1. Children (patients \< 18-years-old) of age are not admitted to the MICU but to the pediatric intensive care unit (PICU) 2. Do Not Resuscitate (DNR), Comfort Care or Moribund 3. Death expected within the next 24 hours 4. Active Bleeding 5. End-stage Renal Disease (ESRD) 6. Chronic Liver Disease: Childs-Pugh Class C and/or Diagnosis of Cirrhosis 7. Tumor Lysis Syndrome 8. Sulfite Allergy: Hepatamine contraindicated. More common in asthmatics. (Please note that this is NOT sulfa allergy and is NOT contraindicated in patients with sulfa allergy) 9. Serum sodium concentration \< 130 milliequivalent (mEq)/L or \>150 mEq/L (Note: Once serum sodium levels are \>/= 130 or \</= 150 mEq/L within 12 hours after meeting inclusion criteria, the patient can then be considered for the study. This is only a temporary restriction.) 10. Serum Creatinine level: SCr \> 2.5 mg/dL (Note: Once serum creatinine levels are =/\< 2.5 mg/dL within 12 hours after meeting inclusion criteria, the patient can then be considered for the study. This is only a temporary restriction.) 11. 11\) Urine output \< 400 cc/24hrs (Note: Once urine output levels are \>/= 400 cc within 12 hours after meeting inclusion criteria, the patient can then be considered for the study. This is only a temporary restriction.) 12. Hyperkalemia K \> 5.5 mEq/L (Note: Once potassium levels are \</= 5.5 mEq/L within 12 hours after meeting inclusion criteria, the patient can then be considered for the study. This is only a temporary restriction.) 13. Hyperglycemia: Glucose \> 250 mg/dL (Note: Once glucose is \</= 250 mg/dL within 12 hours after meeting inclusion criteria, the patient can then be considered for the study. This is only a temporary restriction.) 14. Hyperphosphatemia: Serum Phosphorous \> 8.0 mg/dL 15. Patient with a history of metabolic abnormality in any one of the following amino acids: Alanine, Arginine, Cysteine hydrochloride, Glycine, Histidine, Isoleucine, Leucine, Lysine acetate, Methionine, Phenylalanine, Phosphoric ac-id, Proline, Serine, Threonine, Tryptophan, and Valine.