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Naval Medical Research
and Development
Enterprise Laboratories

NMRC Operational and Undersea Medicine

Urban combatThe Operational and Undersea Medicine Directorate conducts medical research, development, testing, and evaluation to develop new information and technologies to enhance the health, safety, performance, and deployment readiness of Navy and Marine Corps personnel. The Directorate consists of three departments: Undersea Medicine, NeuroTrauma, and Regenerative Medicine.


Undersea Medicine Department

The Undersea Medicine Department focuses on interventions to improve performance and reduce injury in deployed Naval forces engaged in undersea occupations. The undersea medicine program has a unique mission area providing the capability to perform advanced undersea medicine research using animal models. Undersea medicine develops cutting-edge technologies to prevent and treat decompression sickness as well as pulmonary and central nervous system toxicity associated with exposure to hyperbaric oxygen.

Biomedical and clinical research within NMRC's Undersea Medicine program is investigating ways to further increase the safety and improve the operational capabilities of the Explosive Ordnance Detachment (EOD), salvage and husbandry divers, as well as submariners and U.S. Navy SEALs. To that end, several ongoing areas of research are exploring mechanisms and treatment of decompression sickness and oxygen toxicity. Large animal studies in this division are designed for direct applicability to scenarios directly related to U.S. Navy diving and submarine escape.

One focus examines the paradoxical role hyperbaric oxygen (HBO) plays in undersea medicine. HBO has demonstrable benefits in the treatment of decompression sickness and shows promise as a biomedical strategy to support the rescue of survivors in the event of a disabled submarine. However, HBO for extended periods can also compromise the pulmonary system or even induce seizures. Both the therapeutic and toxic effects are currently under study. Other comprehensive physiological studies include central nervous system decompression sickness, pharmacological interventions, and diving acclimation.

Highlights

  • Installed and began operation of a multiple large animal chamber hyperbaric facility.
  • Completed development and implementation of a novel high-resolution data acquisition system to collect physiological signals in simulated operational diving scenarios.
  • Identified mathematically discrete and repeatable electroencephalograph (EEG) precursors to HBO-induced seizures.

Ongoing Studies

  • The role of intermittent air-breaks in pulmonary oxygen toxicity.
  • Accelerated decompression in the 70kg swine.
  • Precision lung slicing in hyperbaric pulmonary oxygen toxicity.
  • Genomics of hyperbaric pulmonary oxygen toxicity.

New Studies

  • Optimizing oxygen pre-breath in a 70kg swine decompression model.
  • Mechanisms of acclimation to decompression illness.
  • Nitric oxide in hyperbaric pulmonary toxicity.
  • Exploration of disabled submarine (DISSUB) rescue protocols in a 70kg swine.
  • Non-invasive sound acquisition in a hyperbaric environment for monitoring pulmonary oxygen toxicity.

NeuroTrauma Department

The NeuroTrauma Department is actively involved in developing novel strategies to prevent and treat combat casualties with particular attention given to developing early, far forward interventions. This includes the Polytrauma Program, which studies traumatic brain injury (TBI) alone or in combination with hemorrhage or other injuries. The Operational Medicine program is primarily focused upon emergent combat injury issues, mainly blast-induced TBI, the importance of which has been spotlighted through the OIF/OEF experience due to the increased use of improvised explosive devices (IEDs). These research efforts include the study of blast biophysics, the pathophysiological responses to blast, neurocognitive and behavioral consequences of blast exposure and treatments for blast injury.

The NeuroTrauma Department at the Naval Medical Research Center (NMRC) conducts research on a variety of topics pertinent to the protection, care, and resuscitation of combat casualties, primarily those occurring in austere circumstances with anticipated delay to definitive care.

The NeuroTrauma Department maintains three major programs. The Blast Research Program consists of human clinical and operational research together with several laboratory model systems. The Operational Medicine Program focuses primarily on emergent militarily relevant issues that could be immediately deployed onto the battlefield. Collaborative efforts with senior trauma surgeons at the Walter Reed National Military Medical Center strengthen the translational value of laboratory evaluations. Research efforts in the Polytraumatics Program are designed to address pre-hospital and early-hospital treatment of combat trauma involving traumatic brain injury (TBI) with and without concomitant injuries (polytrauma) such as hemorrhagic shock (HS), acute respiratory distress syndrome or soft tissue and bone injuries.

The overall goal of the NeuroTrauma Department is to develop, or support development of, new improved field capable therapies and regimens of care that will save lives on the battlefield, en route to definitive care, and during early emergency care.


Regenerative Medicine Department

NMRC’s Regenerative Medicine Department maintains active research efforts in a composite tissue transplantation, stem cell biology, and translational medicine. Department scientists achieved the first successful, heterologous, full skin transplant in a primate model without the use of conventional immunosuppressive drugs. We are also examining the role of mesenchymal stem cells in tissue regeneration and transplantation. The Translational Medicine program conducts both basic and clinical studies in wound healing and tissue regeneration. By identifying the protein and gene expression patterns involved in wound healing, we are working to develop advanced diagnostics and treatment protocols to enhance overall outcomes for combat wounds.

Mission Statement

As one of the world’s premier military laboratories, the Naval Medical Research Center’s Regenerative Medicine Department is committed to cutting-edge translational research and personalized medicine. Our mission is to understand the response to injury and develop improved diagnostics, therapeutics, and decision-support tools for combat-related injuries. The unique collaboration between physicians, scientists, engineers, and mathematicians enables us to bring a broad variety of expertise to bear in an effort to solve important but difficult clinical problems.

Our team leverages real-world experience in combat casualty care to investigate heterotopic ossification, wound healing, immunomodulation of shock, infusible hemostatics, osseointegration, advanced surgical imaging, transplant tolerance and stem cell therapies for tissue regeneration, and radiation injury and testing of radiation countermeasures. In addition, we develop novel and dynamic bioinformatic approaches to deliver point-of-care clinical decision support in an era of personalized medicine.

Our educational programs are vital to our efforts and support graduate medical education by training tomorrow’s clinician scientists. The knowledge and experience they gain in our laboratory is evident in the multitude of national and international presentations, research awards, high-impact peer-reviewed publications, and book chapters - changing the way combat injuries are managed from point of injury to definitive reconstruction.

Combat casualty care is at the center of all we do. Working together with the Department of Surgery at the Uniformed Services University, the Walter Reed National Military Medical Center, and civilian academic partners, our team conducts translational research from the battlefield to the bedside that is designed to benefit the wounded warfighter.

Naval Medical Research Center