Department of Anesthesiology

3.1. Introduction/Overview

The scientific environment at UTMB is characterized by its collegial atmosphere, which facilitates collaborations between scientists across departments and disciplines and will contribute to the success of this project. Several faculty doing research in the areas of neurodegenerative disorders, basic molecular neuroscience, pain mechanisms, addiction, and molecular and structural biology are nearby and interact through regular lab meetings, journal clubs and seminar series.

The University of Texas Medical Branch at Galveston opened in 1891 as the nation’s first public medical school and hospital under unified leadership. What began as one hospital and medical school building in Galveston is now a major academic health sciences center of global influence, with medical, nursing, health professions and graduate biomedical schools; a world-renowned research enterprise; and a growing, comprehensive health system with hospitals on four campuses and a network of clinics. The scientific environment at UTMB is characterized by its collegial atmosphere, which facilitates collaborations between scientists across departments and disciplines and will contribute to the success of this project. Several faculty doing research in the areas of neurodegenerative disorders, basic molecular neuroscience, pain mechanisms, addiction, and molecular and structural biology are nearby and interact through regular lab meetings, journal clubs and seminar series.

With a fertile network of collaborating institutions and rich opportunities for cutting-edge technology applications, UTMB places major emphasis on translational research, providing nearly 400,000 square feet of space specifically designed for research. As a historical component of the University of Texas System and a new member of the Houston-based Texas Medical Center, UTMB has invested considerable resources to develop areas of research strength across the campus and to establish the infrastructure necessary to facilitate basic, clinical and translational research in the 21st century in the face of forecasting deficits across the country.

The Department of Anesthesiology at The University of Texas Medical Branch (UTMB) has maintained a primary focus on research since its establishment more than 75 years ago. The first faculty member in the department upon its creation in 1942 was a physician; he immediately recruited a physiology researcher, Charles R. Allen, PhD, to join him at UTMB as the department’s second faculty member. Dr. Allen subsequently trained as a physician and anesthesiologist, and served as Department Chairman from 1953 to 1977.

The Department of Anesthesiology has made a priority of actively supporting basic, clinical and translational research, through a comprehensive and integrated system of custom-designed laboratories, graduate and post-doctoral fellowships, providing protected time for research faculty and encouraging multidisciplinary research programs in collaboration with other departments and institutions conducting both clinical and basic research. The department currently has major research initiatives, with extramural funding, in the areas of burn injury and smoke inhalation, shock and fluid resuscitation, non-invasive monitoring, and basic and translational aspects of traumatic brain injury.

3.2. Research Initiatives

Charles R. Allen Research Laboratories

The Charles R. Allen Research Laboratories are a 2,500 ft2 facility that includes four small animal surgical and monitoring laboratories, three behavioral outcome assessment laboratories and an animal housing area used for studies of the long-term effects of brain injury and neurodegenerative brain disorders. The space includes four animal research laboratories equipped for aseptic surgery & monitoring, as well as three behavioral assessment laboratories equipped to evaluate the effects of TBI and other brain disorders on memory, vestibulomotor function, neurological function and on brain blood vessels.

There are currently more than five million Americans suffering from traumatic brain injury (TBI), costing the United States more than $56 billion per year. The mechanisms for these injuries include direct mechanical injury to brain cells (shearing forces) or post-injury degeneration of brain tissue that may progress for months to years after the injury. This TBI-induced chronic brain deterioration results in impaired learning and memory loss that may severely impair functioning and increase the risk of developing AD pathology and dementia.  It is well documented that TBI leads to accumulation of toxic amyloid (Ab and tau) oligomers and accelerates the onset of AD-associated cognitive deficits. The sustained activation of the brain's resident macrophages (microglia) and other immune cells has been demonstrated to exacerbate both Ab and tau pathology and may serve as a link between injury-induced neuroinflammation and the pathogenesis of AD. To date, no specific treatment has been proven in clinical trials to improve outcome either after acute TBI or in long-term survivors of TBI.

The main areas of research being conducted at the Charles R. Allen Research Laboratories are:

• acute and chronic cerebral vascular, histological and behavioral effects of impact and blast-induced TBI,
• the development of an innovative non-invasive nanopulsed laser therapy for the treatment of traumatic brain injury and neurodegenerative brain disorders
• mechanisms of  resistance to TBI and Alzheimer’s disease brain pathology and associated dementia.

Translational Intensive Care Unit

The Translational Intensive Care Unit (TICU), occupying 10,000 ft², is designed to provide continuous intensive care to large animals (mostly sheep and pigs) subjected to various disease conditions that closely mimic life-threatening acute morbidities in humans i.e., sepsis, ALI/ARDS, polytrauma such as burn, hemorrhagic shock, spinal cord injury and traumatic brain injury. The TICU consists of a surgical suite, intensive care unit, procedure room, biosafety level-2 suite for bacterial sepsis studies, clinical lab (hematology, micro and molecular biology), autopsy unit, and a sterilization unit. The surgical suite (operation and procedure rooms) exactly mirror hospital operation rooms, enabling us to model various pathological conditions closely mimicking life-threatening human diseases.

The TICU has fully equipped intensive care stations that allow us to simultaneously monitor 24 large animals with various disease conditions for both 24 hours and longer time periods up to 4 weeks. It provides those animals with continuous intensive care 24 hours a day with 3 shifts (day, evening, and night) of highly trained laboratory personnel in a similar manner as is given in a human ICU. The animals are connected to hemodynamic monitors via various vascular catheters, including left atrium of the heart, placed on mechanical ventilators, fluid resuscitated, and treated with different experimental drugs. The animals are attended, daily, by anesthesiologists, surgeons, intensivists, internists, veterinarians, and PhDs to assess the conditions. They collect and interpret the data obtained using various diagnostic and laboratory equipment, such as blood gas analyzer, co-oximeter, coagulation analyzers, complete blood cell counter, pulmonary function test device, and other clinical laboratory devices. Dr. Enkhbaatar discusses the animal condition at daily morning rounds with all lab personnel, including doctors, nurses, scientists, and research associates. The studies performed at the TICU are highly translational. The TICU is a valuable asset not only to UTMB, but nationwide because of uniqueness in its setting and operations.

Integrated with the TICU is the Resuscitation Research Laboratory (RRL), that performs translational research moving concept and invention to prototypes, animal testing, human trials and commercialization. The team evaluates various resuscitation regimens using both animal models and patient studies. The RRL Engineering Division focuses on modeling and device development of software and hardware.

 Immunology Research

Immunology research in the Department of Anesthesiology is led by Dr. Tracy Toliver-Kinsky, whose current research is focused on improving stem cell therapies for wound healing to accelerate recovery from severe burn trauma. Active investigations include the effects of hypoxic environments, such as those found in full-thickness wounds, on adipose-derived stem cell properties and functions associated with normal healing responses.  Additionally, the ability of hydrogen sulfide to precondition adipose-derived stem cells for therapeutic application to wounds is being studied. 

 Pain Research

The UTMB Department of Anesthesiology is an active clinical, research, and educational division of the UTMB academic medical school that has made a priority of actively supporting clinical and translational research. The department currently has major research initiatives, with extramural funding, in the areas of sepsis, lung injury, burn injury and smoke inhalation, toxic gas (phosgene and chlorine), shock and fluid resuscitation, basic and translational aspects of traumatic brain injury, and prevention of prescription opioid misuse and dependence.

The Department includes two outpatient Pain Management Clinics (PMCs), one on Galveston Island on the UTMB campus and another in League City, Texas (approximately 30 miles from Galveston). The PMCs offer a wide variety of services to diagnose and treat patients suffering from chronic pain, and offer expertise in areas of lower back pain, cancer pain, neuropathic pain, and pain from degenerative joint disease. In addition to prescription pain medication management, specialty clinical services include spinal injections, nerve blocks, and physical therapy.

Denise Wilkes, MD, PhD is a clinical provider in the PMCs along with a team of 6 additional anesthesiologists. PMCs are additionally staffed with nurse practitioners, nurses, medical assistants, and a cadre of anesthesiology residents and fellows.

 3.3. Researcher Profiles

 Rovnat Babazade, MD
Assistant Professor

Dr. Babazade attended Istanbul University in Istanbul, Turkey where he received his medical degree and training as a resident of anesthesiology. He received a clinical research fellowship with the Outcomes Research, Anesthesiology Institute at the Cleveland Clinic Foundation, and upon joining the Department of Anesthesiology with the University of Texas Medical Branch, Galveston, he received an obstetrical anesthesia fellowship (2017) and an advanced clinical anesthesia fellowship (2018). In 2022, Dr. Babazade was accepted to be an American Board of Anesthesiology certified anesthesiologist through the Alternate Entry Pathway (Research).  Having set the foundation for his clinical career, his research interest is centered around opioid use disorder, perioperative opioid usage, perioperative outcomes, acute pain, labor epidural analgesia, epidural catheter tip identification, and obstetric anesthesia and analgesia. In support of his research efforts, Dr. Babazade continues to cultivate his interest through publications and grant support highlighted in a limited list below.

Epidural blood patch for a post-dural puncture headache in a COVID-19 positive patient following labor epidural analgesia. Ibrahim M, Darling R, Oaks N, Babazade R, Vadhera R. Int J Obstet Anesth. 2021 Mar 10;46:102970. doi: 10.1016/j.ijoa.2021.102970. PMID: 33780713

Anesthetic Management and 30-Day Outcomes After Renal Autotransplantation. Babazade R, Devarajan J, Bonavia AS, Saweris Y, O’Hara J, Avitsian R, Elsharkawy H. Ochsner Journal. Volume 20, Number 3, Fall 2020. DOI: 10.31486/toj.19.0086

Acute Postoperative Pain Is Associated With Myocardial Injury After Noncardiac Surgery. Turan A, Leung S, Bajracharya GR, Babazade R, Barnes T, Schacham YN, Mao G, Zimmerman N, Ruetzler K, Maheshwari K, Esa WAS, Sessler DI. Anesth Analg. 2020 Jul 7. doi: 10.1213/ANE.0000000000005033.PMID: 3266547

 Grant Support:

CON26454 - The Cleveland Clinic Foundation (2017-2021), "Comparison of Bilateral Transversus Abdominis Plane Block with Exparel versus Continuous Epidural Analgesia with Bupivacaine: A Randomized, Controlled Trial"

CON28050 - Milestone Scientific Inc (2019-2020), "CompuFlo Epidural Instrument Cost Effectiveness Study"

CON28232 - Pacira Pharmaceuticals Inc (2019-2021), " Multicenter, Randomized, Active-Controlled Study to Evaluate the Efficacy and Safety of EXPAREL When Administered via Infiltration into the Transversus Abdominis Plane versus Standard of Care in Subjects Undergoing Elective Cesarean Section"

 Douglas S. DeWitt, PhD
Professor and Director, Charles R. Research Laboratories

Dr. Douglas DeWitt attended Denison University in Granville, Ohio, where he received his bachelor’s in biology and subsequently received his Ph.D., in anatomy and neuroscience from the University of Cincinnati in Cincinnati, Ohio. As part of his post-doctoral fellowship in the Division of Neurological Surgery, he attended the Medical College of Virginia and Virginia Commonwealth University in Richmond, Virginia under the mentorship of Drs. Ronald L. Hayes and John T. Povlishock. 

As a trained neuroscientist, Dr. DeWitt’s clinical and research interest is focused on the acute and chronic cerebral vascular, histological and behavioral effects of impact and blast-induced traumatic brain injury. To his credit, Dr. DeWitt continues to cultivate his research interest through publications and grant support highlighted in a limited list below.

Sowers JL, Sowers ML, Shavkunov AS, Hawkins BE, Wu P, DeWitt DS, Prough DS, Zhang K. Traumatic brain injury induces region-specific glutamate metabolism changes as measured by multiple mass spectrometry methods. iScience. 2021 Sep 9;24(10):103108. doi: 10.1016/j.isci.2021.103108. PMID: 34622161; PMCID: PMC8479783.

Weisz HA, Kennedy D, Widen S, Spratt H, Sell SL, Bailey C, Sheffield-Moore M, DeWitt DS, Prough DS, Levin H, Robertson C, Hellmich HL. MicroRNA sequencing of rat hippocampus and human biofluids identifies acute, chronic, focal and diffuse traumatic brain injuries. Sci Rep. 2020 Feb 24;10(1):3341. doi: 10.1038/s41598-020-60133-z. PMID: 32094409; PMCID: PMC7040013.

Fujiwara O, Fukuda S, Lopez E, Zeng Y, Niimi Y, DeWitt DS, Herndon DN, Prough DS, Enkhbaatar P. Peroxynitrite decomposition catalyst reduces vasopressin requirement in ovine MRSA sepsis. Intensive Care Med Exp. 2019 Sep 9;7(1):12. doi: 10.1186/s40635-019-0227-4. PMID: 31512009; PMCID: PMC6738358.

Sell SL, Boone DR, Weisz HA, Cardenas C, Willey HE, Bolding IJ, Micci MA, Falduto MT, Torres KEO, DeWitt DS, Prough DS, Hellmich HL. MicroRNA profiling identifies a novel compound with antidepressant properties. PLoS One. 2019 Aug 23;14(8):e0221163. doi: 10.1371/journal.pone.0221163. PMID: 31442236; PMCID: PMC6707633.

Grant Support:

The Moody Foundation, “The Moody Project for Translational Traumatic Brain Injury Research” (2013-2018)

USAMRMC/CDMRP, “Mission Connect Mild TBI Translational Research Consortium” (2008-2014)

NIH/NINDS, "Effects of O2 Radical & Perivascular Nerves in Trauma" (2005-2012)

 Perenlei Enkhbaatar, MD, PhD, FAHA
Tenured Professor, Charles Robert Allen Professor of Anesthesiology
Director of the UTMB Translational Intensive Care Unit

Dr. Perenlei Enkhbaatar received his medical degree from the Military Medical Academy in Saint Petersburg, Russia. Dedicating several years to the Mongolian Armed Forces, he served as Senior Lieutenant, as well as a physician for the Army Hospital in Mongolia, and subsequently received his PhD., from Kumamoto University Graduate School of Medical Sciences in Japan. Upon transitioning to the United States, he received a post-doctoral fellowship with the anesthesiology department at the University of Texas Medical Branch, Galveston. Because of his scientific and professional accomplishments, in 2014 Dr. Enkhbaatar was elected to one of the world’s most eminent organizations of cardiovascular and stroke professionals, as a Fellow of American Heart Association (FAHA). Dr. Enkhbaatar has been awarded with numerous federal (i.e., NIH, American Heart Association [AHA], Department of Defense [DoD], Office of Naval Research) and industrial grants, and served as a Chair of the American Heart Association study section, as well as various NIH and DoD study sections as an ad hoc Reviewer. Dr. Enkhbaatar also serves as an Editorial Board Member in numbers of prestigious critical care journals, such as Critical Care Medicine, Shock, Burns &Trauma, and Burn Care & Research as well as Associate Editor in Frontiers in Immunology.

The primary focus of Dr. Enkhbaatar’s research is to investigate pathophysiology of multiorgan dysfunctions during critical illnesses requiring intensive care, such as sepsis, burn trauma, cardiopulmonary dysfunctions, and toxic gas inhalation with emphasis on microvascular hyper-permeability, interplay between inflammation and coagulopathy, nitric oxide biology, and tissue regeneration. His ultimate goal is to develop a novel, safe, and effective treatment strategy for these critical illnesses with a special focus on stem cell and other cellular therapies. Dr. Enkhbaatar has published more than 175 peer-reviewed manuscripts and book chapters and continues to cultivate his research interest through publications and grant support highlighted in a limited list below. 

 Burmeister DM, Supp DM, Clark RA, Tredget EE, Powell HM, Enkhbaatar P, Bohannon JK, Cancio LC, Hill DM, Nygaard RM. Advantages and Disadvantages of Using Small and Large Animals in Burn Research: Proceedings of the 2021 Research Special Interest Group. J Burn Care Res. 2022 Sep 1;43(5):1032-1041. doi: 10.1093/jbcr/irac091. PMID: 35778269.

Lucas R, Hadizamani Y, Enkhbaatar P, Csanyi G, Caldwell RW, Hundsberger H, Sridhar S, Lever AA, Hudel M, Ash D, Ushio-Fukai M, Fukai T, Chakraborty T, Verin A, Eaton DC, Romero M, Hamacher J. Dichotomous Role of Tumor Necrosis Factor in Pulmonary Barrier Function and Alveolar Fluid Clearance. Front Physiol. 2022 Feb 21;12:793251. doi: 10.3389/fphys.2021.793251. PMID: 35264975; PMCID: PMC8899333.

Fukuda S, Niimi Y, Hirasawa Y, Manyeza ER, Garner CE, Southan G, Salzman AL, Prough DS, Enkhbaatar P. Modulation of oxidative and nitrosative stress attenuates microvascular hyperpermeability in ovine model of Pseudomonas aeruginosa sepsis. Sci Rep. 2021 Dec 14;11(1):23966. doi: 10.1038/s41598-021-03320-w. PMID: 34907252; PMCID: PMC8671546.

El Ayadi A, Salsbury JR, Enkhbaatar P, Herndon DN, Ansari NH. Metal chelation attenuates oxidative stress, inflammation, and vertical burn progression in a porcine brass comb burn model. Redox Biol. 2021 Sep;45:102034. doi: 10.1016/j.redox.2021.102034. Epub 2021 Jun 8. PMID: 34139550; PMCID: PMC8218731.

Grant Support:

NIH GM097480, “Etiology of Microvascular Changes in Gram-positive Sepsis: Mechanisms and Therapeutic Options” (2012–2023)

NIH R01HL148781, “Therapeutic Use of High Molecular Weight Hyaluronic Acid in Acute Lung Injury Following Severe Bacterial Pneumonia or Sepsis” (2020–2024)

Department of Defense, “Nebulized epinephrine in burn and smoke inhalation injury” (2012-2017)

 Helen L. Hellmich, PhD
Associate Professor

Dr. Hellmich attended the University of Pennsylvania, Philadelphia, where she received her bachelor’s in biology and subsequently received her master’s and PhD in zoology from the University of Massachusetts, Amherst. She completed her postdoctoral training as an intramural research fellow at the National Institute of Neurological Disorders and Stroke and subsequently, at the National Institute of Mental Health in Bethesda, Maryland. Upon joining the University of Texas Medical Branch in 1996, she first served as a postdoctoral research associate in the laboratory of Dr. Burgess Christensen and subsequently as an Instructor in Internal Medicine in the department of Gastroenterology. After joining the Anesthesiology department in 2000 as an Assistant Professor, Dr Hellmich has since dedicated her professional career to research involving the molecular mechanisms of neurodegeneration and neuronal survival after traumatic brain injury (TBI). She has also studied the effects of age on susceptibility to TBI, the influence of circadian dysfunction on functional outcome after TBI, epigenetic dysregulation of injury-induced gene expression after TBI, and in recent years, small, non-coding microRNAs as blood biomarkers of brain injury, diverse human diseases and Covid-19. She is currently semi-retired, no longer performing laboratory research and teaching, but continues to cultivate her research interests through in silico analysis of publicly available genomic datasets and is collaborating with Dr. Prough and with physicians who are treating Covid-19 patients in an ongoing clinical study of blood miRNAs as biomarkers of long Covid in patients who have recovered from SARS-CoV-2 infections.

Sell SL, Prough DS, Weisz HA, Widen SG, Hellmich HL. Leveraging publicly available coronavirus data to identify new therapeutic targets for Covid-19. PLoS One. 2021 Sep 29;16(9):e0257965. doi: 10.1371/journal.pone.0257965.

Sell SL, Widen SG, Prough DS, Hellmich HL. Principal component analysis of blood microRNA datasets facilitates diagnosis of diverse diseases. PLoS One. 2020 Jun 5;15(6):e0234185. doi: 10.1371/journal.pone.0234185.

Weisz HA, Kennedy D, Widen S, Spratt H, Sell SL, Bailey C, Sheffield-Moore M, DeWitt DS, Prough DS, Levin H, Robertson C, Hellmich HL. MicroRNA sequencing of rat hippocampus and human biofluids identifies acute, chronic, focal and diffuse traumatic brain injuries. Scientific Reports 2020 Feb 24;10(1):3341. doi: 10.1038/s41598-020-60133-z.

Boone DR, Weisz HA, Bi M, Faldulto MT, Torres KEO, Willey HE, Volsko CM, Kumar AM, Micci MA, DeWitt DS, Prough DS, Hellmich HL Evidence linking microRNA suppression of essential prosurvival genes with hippocampal cell death after traumatic brain injury. Scientific Reports 2017 Jul 27;7(1):6645. doi: 10.1038/s41598-017-06341-6.

Rojo DR, Prough DS, Falduto MT, Boone DR, Micci MA, Kahrig KM, Crookshanks JM, Jimenez A, Uchida T, Cowart JC, Hawkins BE, Avila M, DeWitt DS, Hellmich HL. Influence of stochastic gene expression on the cell survival rheostat after traumatic brain injury. PLoS One 2011 6(8):e23111.

Grant Support:

Department of Defense (DoD) DM180663 (2019-2021)

“Nano-Pulsed Laser Optoacoustic Therapy for Pre- and Post-Treatment of Traumatic Brain Injury” The goal of this project was to evaluate nano-pulsed laser optoacoustic technology as a possible therapy for TBI.

The Moody Foundation (2014-2018)

“Gene Expression After TBI”

 Michael P. Kinsky, MD
Tenured Professor and James F Arens Chair in Anesthesiology
Director of the Clinical Research Center, UTMB Institute for Translational Sciences

Dr. Kinsky attended Texas A&M University - Galveston, where he received his bachelor’s in marine biology and subsequently received his medical degree from the University of Texas Medical Branch (UTMB), Galveston. On the rise to begin a lengthy career on the foundation of his alma mater, Dr. Kinsky completed his residency with the UTMB Department of Anesthesiology and continued to serve as chief resident throughout his cardiothoracic fellowship).

As a trained cardiothoracic anesthesiologist, Dr. Kinsky’s clinical and research interest is centered on cardiopulmonary disease and distress. His research program is focused on ways to improve cardiopulmonary function so that more efficient strategies can be instituted. He is the principal investigator and co-investigator on both Department of Defense and NIH grants, as well as industry sponsored trials. As UTMB’s Vice Chair for Research and the Clinical Director of the Resuscitation Research Laboratory, and Director of the Institute for Translational Sciences Clinical Research Center (ITS-CRC), Dr. Kinsky has a broad background in physiology and anesthesiology with specific expertise in resuscitation science, pathophysiology of burn injury, pharmacologic agents, and echocardiography. Additionally, he serves on the Institutional Review Board and the ITS - Scientific Review Committee. His high degree of familiarity with translational sciences along with his clinical expertise is an asset for many diseases in need of novel therapeutics, devices, and other approaches. Dr. Kinsky continues to cultivate his research interest through publications and grant support highlighted in a limited list below.

Cunningham C, Tapking C, Salter M, Seeton R, Kramer GC, Prough DS, Sheffield-Moore M, Kinsky MP. The physiologic responses to a fluid bolus administration in old and young healthy adults. Perioper Med (Lond). 2022 Aug 16;11(1):30. doi: 10.1186/s13741-022-00266-z. PMID: 35971161; PMCID: PMC9380305.

Sampson CM, Khan MN, Kinsky MP. FIO2: An Inspired Solution for a Universal Problem. Respir Care. 2021 Oct;66(10):1636-1637. doi: 10.4187/respcare.09552. PMID: 34552018.

Bergmeister KD, Aman M, Kramer A, Schenck TL, Riedl O, Daeschler SC, Aszmann OC, Bergmeister H, Golriz M, Mehrabi A, Hundeshagen G, Enkhbaatar P, Kinsky MP, Podesser BK. Simulating Surgical Skills in Animals: Systematic Review, Costs & Acceptance Analyses. Front Vet Sci. 2020 Sep 30;7:570852. doi: 10.3389/fvets.2020.570852. PMID: 33195561; PMCID: PMC7554573.

Tapking C, Popp D, Herndon DN, Branski LK, Hundeshagen G, Armenta AM, Busch M, Most P, Kinsky MP. Cardiac Dysfunction in Severely Burned Patients: Current Understanding of Etiology, Pathophysiology, and Treatment. Shock. 2020 Jun;53(6):669-678. doi: 10.1097/SHK.0000000000001465. PMID: 31626036.

Grant Support:

US Army BA160657 “Smart Oxygenation Systems (SOS) Provides Early Warning of Lung Injury” (2018-2022)

US Air Force FA8650-19-2-6G32 “Automated Assessment of Pulmonary Mechanics & fluid Responsiveness” (2019-2022)

National Center for Advancing Translational Sciences. “Clinical and Translational Science Award (CTSA)” (2019-2024)

 George Calvert Kramer, PhD.
Professor Emeritus, Director of the Resuscitation Research Laboratory

Dr. Kramer received his bachelor’s in physics while in the U.S. Air Force Academy, Colorado Springs, Colorado and a second bachelor’s in meteorology from San Jose State University in California. Preparing his professional foundation in research, he attended the University of California, San Diego, where he received his master’s in bioengineering, and subsequently his PhD in physiology while attending the University of Texas Medical Branch at Galveston.

As a research scientist, Dr. Kramer’s major research interest is the microcirculatory transport of fluid and macromolecules, including developing effective and efficient approaches for fluid and drug therapy for treatment of trauma, burns and sepsis. The Resuscitation Research Lab performs translation research moving concept and invention to prototypes, animal testing, human trials and commercialization. As one of the pioneers in developing automated closed loop and decision assist resuscitation protocols and devices to be used for combat casualty care and prehospital trauma, Dr. Kramer continues to cultivate his research interest through publications and grant support highlighted in a limited list below.

Marques NR, Brent J Ford, Muzna Khan, Michael Kinsky, Donald J Deyo, William J Mileski, Hao Ying, George C Kramer.  Automated Closed-loop Resuscitation of Multiple Hemorrhages: A Comparison between Fuzzy Logic and Decision Table Controllers in a Sheep Model.  Disaster and Military Medicine.3:1 eCollection 2017.  PMID: 28265453

Marques, NR, William E Whitehead, Upendar R Kallu, Michael P Kinsky, Joe S Funston, Taoufik Wassar, Muzna N Khan, Mindy Milosch, Karolos Grigoriadis, George C Kramer, Ph.D.  Physician Directed versus Computerized Closed-Loop Control of Blood Pressure Using Phenylephrine in a Swine Model. Anesth Analg. 125:110-116, 2017 , PubMed PMID: 28368937.

Yaghouby F, Daluwatte C, Fukuda S, Nelson C, Salsbury J, Kinsky M, Kramer GC, Strauss DG, Enkhbaatar P, Scully CG. Progression and variability of physiologic deterioration in an ovine model of lung infection sepsis. J Appl Physiol 123:172-181, 2017. PMID: 28473609.

Grant Support:

US Army (2020-2023), “Semi-and Autonomous Casualty Management (SACM)” Part of the US Army Task Area – Autonomous and Unmanned Medical Capability

W81XWH-19-1-0322 - US Army (2019-2021), “Mathematical Modeling of Hemodynamics in Trauma-Induced Shock and Closed-Loop Trauma Resuscitation”

US Army American Burn Association (2017-2020), “Evaluation of the effectiveness of the Burn Navigator in improving resuscitation outcomes”

 Maria-Adelaide Micci, PhD
Tenured Associate Professor

Prior to joining the University of Texas Medical Branch (UTMB) at Galveston in 2009, Dr. Micci received her doctorate in biological sciences from the University of Rome “La Sapienza” in Rome, Italy, and subsequently a Doctor of Philosophy Degree in Cell Biology from the UTMB Graduate School of Biomedical Sciences. As part of her lengthy professional career with the anesthesiology department, Dr. Micci is an active teacher, mentor, standing member of several committees, recipient of numerous awards, and has co-patented inventions that help propel her interest in stem cells, neurological dysfunction, and traumatic brain injury.

As a trained cell biologist, Dr. Micci has dedicated her research interest to the development of non-invasive transcranial applications of nano pulsed laser therapy for the treatment of traumatic brain injury and neurodegenerative brain disorders; regulation of neurogenesis following traumatic brain injury and in neurodegenerative disorders; and induction of resistance to Alzheimer’s disease pathology using neural stem cells-derived exosomes. For this reason, Dr. Micci continues to cultivate her research interest through publications and grant support highlighted in a limited list below.

Sell SL, Boone DR, Weisz HA, Cardenas C, Willey HE, Bolding IJ, Micci MA, Falduto MT, Torres KEO, DeWitt DS, Prough DS, Hellmich HL. MicroRNA profiling identifies a novel compound with antidepressant properties. PLoS One. 2019 Aug 23;14(8).

Micci MA, Krishnan B, Bishop E, Zhang WR, Guptarak J, Grant A, Zolochevska O, Tumurbaatar B, Franklin W, Marino C, Widen SG, Luthra A, Kernie SG, Taglialatela G. Hippocampal stem cells promotes synaptic resistance to the dysfunctional impact of amyloid beta oligomers via secreted exosomes. Mol Neurodegener. 2019 Jun 14;14(1):25.

Krishnan B, Sallam HS, Tumurbataar B, Saieva S, Baymon D, Tuvdendorj D, Micci MA, Abate N, Taglialatela G. Amelioration of hippocampal dysfunction by adipose tissue-targeted stem cell transplantation in a mouse model of type 2 diabetes. J Neurochem. 2020 Apr;153(1):51-62

Mocciaro, A. Grant, R. Esenaliev, I. Petrov, Y. Petrov, S.L. Sell, N.L. Hausser, J. Guptarak, E. Bishop, M.A. Parsley, I.J Bolding, K.M. Johnson, M. Lidstone, D.S. Prough, M.A. Micci. Non-invasive transcranial nano-pulsed laser therapy ameliorates cognitive function, stimulates neuronal maturation and prevents aberrant migration of neural progenitor cells in the hippocampus of rats subjected to traumatic brain injury. J Neurotrauma 2020 Apr 15;37(8):1108-1123

Grant Support (past 3 years):

NIH/NINDS Type R01, “Nano-Pulsed Optoacoustic Neuromodulation for Reducing Traumatic Brain Injury- Driven Neuropathology and Improving Cognitive Outcome” (2022-2027)

NIH/NIA Type R01, “Promoting Brain Resilience to Alzheimer’s Neuropathology” (2020–2025)

DoD Type: DMRDP AIMM Research Program, “Nano-pulsed Laser Optoacoustic Therapy for Pretreatment and Posttreatment of Traumatic Brain Injury” (2019-2022)

NIH/NIA Type: R56, “Mechanisms of Resilience to Alzheimer’s Disease Neuropathology” (2019-2021)

 Donald Sanderson Prough, MD
Professor and Rebecca Terry White Distinguished Chair

Dr. Prough received his medical degree from Pennsylvania State University College of Medicine in Hershey, Pennsylvania, and subsequently completed his fellowship in cardiac anesthesia from the University of Alabama. Over the next four years, he completed a fellowship in critical care medicine, an anesthesiology residency, and internship all from the National Naval Medical Center in Bethesda, MD. Additionally, he holds honorary fellowships with the Fellow College of Chest Physicians (FCCP) and the Fellow American Society of Anesthesiologists (FASA).

Trained in cardiac anesthesia, Dr. Prough’s research focus includes the following: determination of the roles of zinc and vascular function in the pathogenesis of brain injury in rats; determining the effect of aging on the host response to head trauma; and neurotrauma. Specifically, the study of volume kinetic and mass balance analysis of responses to fluid infusion. Along with serving on several studies and patented inventions, Dr. Prough is the co-founder of Noninvasix, Inc., a medical technology company that has developed a novel solution to non-invasively monitor, for the first time, oxygen sufficiency in organs and veins. Because of his scientific and professional accomplishments, Dr. Prough has been elected into one of the world’s most eminent organizations of cardiovascular and stroke professionals, having received the Fellow of American Heart Association (FAHA) recognition. To date, he continues to cultivate his research interest through publications and grant support highlighted in a limited list below.

Cunningham C, Tapking C, Salter M, Seeton R, Kramer GC, Prough DS, Sheffield-Moore M, Kinsky MP. The physiologic responses to a fluid bolus administration in old and young healthy adults. Perioper Med (Lond). 2022 Aug 16;11(1):30. doi: 10.1186/s13741-022-00266-z. PMID: 35971161; PMCID: PMC9380305.

Weisz HA, Boone DR, Coggins WS, Edwards GA, Willey HE, Widen SG, Siegel D, Nelson AT, Prough DS, Hellmich HL. Mechanistic insights gained from cell and molecular analysis of the neuroprotective potential of bioactive natural compounds in an immortalized hippocampal cell line. PLoS One. 2022 Jun 3;17(6):e0267682. doi: 10.1371/journal.pone.0267682. PMID: 35657963; PMCID: PMC9165808.

Fukuda S, Niimi Y, Hirasawa Y, Manyeza ER, Garner CE, Southan G, Salzman AL, Prough DS, Enkhbaatar P. Modulation of oxidative and nitrosative stress attenuates microvascular hyperpermeability in ovine model of Pseudomonas aeruginosa sepsis. Sci Rep. 2021 Dec 14;11(1):23966. doi: 10.1038/s41598-021-03320-w. PMID: 34907252; PMCID: PMC8671546.

Sowers JL, Sowers ML, Shavkunov AS, Hawkins BE, Wu P, DeWitt DS, Prough DS, Zhang K. Traumatic brain injury induces region-specific glutamate metabolism changes as measured by multiple mass spectrometry methods. iScience. 2021 Sep 9;24(10):103108. doi: 10.1016/j.isci.2021.103108. PMID: 34622161; PMCID: PMC8479783.

Sell SL, Prough DS, Weisz HA, Widen SG, Hellmich HL. Leveraging publicly available coronavirus data to identify new therapeutic targets for COVID-19. PLoS One. 2021 Sep 29;16(9):e0257965. doi: 10.1371/journal.pone.0257965. PMID: 34587192; PMCID: PMC8480897.

 Grant Support:

NIH “Optoacoustic Assessment of Hemoglobin Concentration. Principal Investigator of Subaward from Noninvasix STTR” (2018-2019)     

“Moody Project on Translational Traumatic Brain Injury Research” (2014-2018)

“Rapid and Safe Assessment of Circulatory Shock with a Novel Noninvasive Technique” Dept. of the Army, Military Medical Research and Development. (2011-2013)

 Tracy Toliver-Kinsky, PhD
Professor and Director of Basic Biomedical Science Curriculum

Dr. Toliver-Kinsky attended Southwest Texas State University where she received her bachelor’s and master’s in biology, and subsequently continued her studies at the Graduate School of Biomedical Sciences with the University of Texas Medical Branch (UTMB), Galveston, receiving her PhD., in human biochemistry and genetics. As part of her post-graduate training, Dr. Toliver-Kinsky completed a postdoctoral fellowship with the UTMB Department of Anesthesiology with a focus on trauma and burn research.

As a trained human biochemistry and genetics scientist, Dr. Toliver-Kinsky has devoted her career to research in the effort to understanding how the immune system is dysregulated after severe trauma and how it can be manipulated pharmacologically to decrease the incidence of life-threatening infections, accelerate wound healing, and regulate metabolism after injury. Additionally, her primary research focus includes the immunological responses to trauma, immunomodulation, dendritic cell and neutrophil biology, wound healing mechanisms, hydrogen sulfide regulation of host and pathogen responses to infection, stem cell regenerative therapy, and the role of immune system in the hypermetabolic response to burn trauma.  Dr. Toliver-Kinsky continues to cultivate her research interest through publications and grant support highlighted in a limited list below.

Dilek N, Papapetropoulos A, Toliver-Kinsky T, Szabo C (2020). Hydrogen sulfide: An endogenous regulator of the immune system. Pharmacological Research 161: 105119. Online ahead of print. PMID: 32781284

Blears E, Sommerhalder C, Toliver-Kinsky T, Finnerty CC, Herndon DN (2020).  Current problems in burn immunology. Current Problems in Surgery 57(6): 100779. PMID: 32507131

Ahmad A, Vieira JC, de Mello AH, de Lima TM, Ariga SK, Barbeiro DF, Barbeiro HV, Szczesny B, Toro G, Druzhyna N, Randi EB, Marcatti M, Toliver-Kinsky T, Kiss A, Liaudet L, Salomao R, Soriano FG, Szabo C (2019). The PARP inhibitor olaparib exerts beneficial effects in mice subjected to cecal ligature and puncture and in cells subjected to oxidative stress without impairing DNA integrity: A potential opportunity for repurposing a clinically used oncological drug for the experimental therapy of sepsis. Pharmacological Research 145: 104263. PMID: 31071432

Grant Support:

NIH 1R01GM136877-01A1 (2020-2024),Enhancement of stem cell regenerative properties by hydrogen sulfide: a novel wound dressing to augment stem cell therapies.

Institute for Human Infections & Immunity, UTMB  (2019-2020), New host-directed therapeutics to combat multi-drug resistant pathogens in burn injury

Shriners Hospitals for Children (2017-2019), Inhibition of Bacterial and Host-Derived H2S Production for the Therapeutic Enhancement of Anti-Bacterial Host Defense in Burns

 Denise M. Wilkes, MD, PhD
Professor, Department of Anesthesiology and Pain Medicine

Dr. Denise Wilkes attended the University of California at Berkeley where she received her bachelor’s in bioresource sciences before beginning her long career with the University of Texas Medical Branch (UTMB) at Galveston. As part of her foundation with UTMB, Dr. Wilkes attended the university’s Graduate School of Biomedical Sciences where she received her PhD, in cellular physiology and molecular physics. She subsequently attended the university’s School of Medicine where she received her medical degree, post-graduate training, and a fellowship with the Department of Anesthesiology Pain Management.

As a pain medicine clinician, Dr. Wilkes measures opioid compliance in patients by urine drug tests, pharmacy records, and pill counts along with the potential for nonmedical use of pain medications through imperfect survey tools. None of these tests indicate how patients take their opioids nor pinpoint those at the greatest risk for opioid misuse, overdose or opioid use disorder (OUD). As such, Dr. Wilkes has devoted her studies to focus on technologies to directly measure opioid use and involve investigating the clinical use of opioids and chronic neuropathic pain. The two areas of her focus are: 1) Develop methods to directly monitor how patients take their pain medications; and 2) Use a large mammalian model to study the efficacy and safety of therapeutic alternatives prior to clinical trials and to induce gene expression in peripheral nerves. To her credit, Dr. Wilkes continues to cultivate her research interest through publications and grant support highlighted in a limited list below.

Denise M. Wilkes, Susan J. Orillosa, Eric C. Hustak, Courtney G. Williams, Gulshan R. Doulatram, Daneshvari R. Solanki, Eduardo A. Garcia and Li-Yen M. Huang. Efficacy, Safety, and Feasibility of the Morphine Microdose Method in Community-Based Clinics. Pain Medicine. 2017 Jun 13

Ngo, J., Parker, D., Meroney, M., Mitchell, J., Veloz, O., Lee, L., Cunningham, KM., and Wilkes, D. Quantification of Opioid Prescription Practice Changes Due to Hydrocodone Combination Product Rescheduling in an Academic Pain Clinic. J Pain Res 13:2163-2168, 2020

Polychronopoulou, E., Kuo, YF., Wilkes D., and Raji MA. Prescribing of Gabapentinoids with or without opioids after burn injury in the US. 2012-2018. Burns. 2021 Dec 22.

Grant Support:

NIH, “Understanding the Mechanistic, Neurophysiological, and Antinociceptive Effects of Transcutaneous Auricular Neurostimulation for Treatment of Chronic Pain” (NS128787), 09/2022 – 07/2027, $1,910,070 total costs in Year 01.

Medtronic Licensing agreement (2017 – current), Patented sheep model is licensed to Medtronic to develop spinal cord stimulation product.

R01 DA039192 01A1, Pattern, Variation, and Outcomes of Opioid Prescription in Older Adults

NCATS, “Discovery of Phenotype Profiles Predicting Opioid Use Disorder in Chronic Pain”

 Satoshi Yamamoto, MD
Assistant Professor

Dr. Yamamoto attended Yamaguchi University Faculty of Medicine, Japan, where he received his medical degree, followed by his residency in emergency medicine with Mizushima Kyodo Hospital, Japan, a subsequent residency in anesthesiology with Teikyo University Hospital, Japan, a fellowship in medical education with Stanford University, California, as well as completing a fellowship in neuroanesthesia, anesthesiology with the University of Texas Medical Branch at Galveston. Additionally, he is a member of good standing with the American Society of Anesthesiologists, the International Anesthesia and Research Society, and the Japanese Association for Acute Medicine.

As part of his clinical background, Dr. Yamamoto started with extensive training during his emergency medicine residency. As he became skilled in the critical care for severely ill patients, research-related questions involving his clinical practice became increasingly apparent each day. It was during his extensive neuroanesthesia experience at the University of Washington that he realized there were considerable amounts of severe traumatic brain injury patients that suffered from unfavorable outcomes. It would be those experiences that inspired Dr. Yamamoto to pursue academic medicine. As a result, he continues to devote his work on the advancement of research, including publications and grant support highlighted in a limited list below.

Todoroki-Ikeda N, Shirao S, Sato S, Yamamoto S, et al.  “Evaluation of Signal Transduction in Vascular Smooth Muscle by a Membrane-Permeability Technique.” Yamaguchi Medical Journal, 49 (4): 449-451 (2000).

Yamamoto S, Levin HS, Prough DS. Mild, Moderate and Severe: Terminology Implications for Clinical and Experimental Traumatic Brain Injury. Curr Opin Neurol. Dec;31(6):672-680 2018. PMID: 30379702

Yamamoto S, DeWitt DS, Prough DS. “Impact & Blast Traumatic Brain Injury: Implications for Therapy.” Molecules Jan 26;23(2). 2018. PMID: 29373501 PMCID: PMC6017013

 Clinician Scientists

The Department of Anesthesiology is fortunate to have a number of faculty who, although their primary focus is providing professional clinical services, nonetheless devote a substantial amount of time to research in the areas of translational studies, quality assurance studies, and educational strategies. The Department of Anesthesiology’s Clinician Scientists include:

 Joaquin Cortiella, MD, MPH
Professor

Dr. Cortiella attended Harvard University in Boston, Massachusetts, where he received his master’s in public health and subsequently received his medical degree from Boston University Medical School. His post-training includes a pediatric internship and junior residency with Boston City Hospital, a pediatric senior residency with the Children’s Hospital in Boston, a post-doctoral fellow in Nutrition and Biochemistry with the Massachusetts Institute of Technology, and an anesthesiology residency with Massachusetts General Hospital, in Boston. Coupled with his academic success, teaching and committee responsibilities, Dr. Cortiella has also dedicated several years to the U.S. Army. Retiring as Colonel in 2014, he’s served the Medical Corps, Medical Readiness Training Command, and the U.S. Army Reserves at Fort Sam Houston, San Antonio, TX. Additionally, he’s been awarded the Bronze Star (2007), a Combat Action Badge (2013), both with operations Iraq, as well as the Legion of Merit Medal (2016).

As an expert on tissue engineering and the cell biology of stem cells, Dr. Cortiella continues to cultivate his research interest through publications and grant support

 Lisa Farmer, MD
Associate Professor
Medical Director, UTMB Perioperative Blood Management Program

Dr. Farmer’s scholarship focuses on educational and quality improvement research. Her educational interests are curriculum development for the Anesthesiology Observed Structured Clinical Exam, and generational learning. Her quality improvement work focuses on various aspects of patient blood management. 

 Sean Funston, MD
Professor and Vice Chair for Clinical Operations

Dr. Funston attended Midwestern State University in Wichita Falls, Texas, where he received his Bachelor of Science with a major in chemistry and biology. He received his Doctor of Medicine from the University of Texas Medical Branch at Galveston in 1994 and completed his residency with the UTMB Department of Anesthesiology in 1998, where he was selected as chief resident. He completed a critical care fellowship in 1999 and joined the faculty of the department of anesthesiology full time after completion. He has served many roles in the department and is now Vice Chair for Clinical affairs. He has no protected research time but has worked closely with departmental researchers in translational research. As a critical care anesthesiologist, Dr. Funston’s clinical and research interest is centered on monitoring and resuscitation of shock. His research is focused on ways to improve cardiopulmonary monitoring and function so that more efficient strategies can be instituted to improve care. Currently he is working on proof of concept non-invasive saturation monitor.

 Janos Geli MD, PhD, EDAIC
Assistant Professor

Dr Geli joined UTMB in 2021 from the renowned Karolinska Institute in Sweden. He completed his PhD thesis in 2007 focusing on the molecular genetic alterations the driving neoplastic process in pheochromocytomas and neuroblastomas. During his PhD years he identified for the first time the methylator epigenetic phenotype in malignant pheochromocytomas and paragangliomas. He completed his residency in Sweden in 2015. Post residency he underwent training in pediatric anesthesia and critical care as well as adult cardiothoracic anesthesia and critical care. He is a diplomate of the European Society of Anesthesia and Critical Care (EDAIC). Currently his main interest is translational studies in critical care, ECMO and hemostasis

Ronald Levy, MD
Professor (Tenured)

Dr. Levy's  attended the University of Rochester, Rochester, NY, where he received his Bachelor of Arts with a major in biology. He received his Doctor of Medicine from the Sackler School of Medicine and completed his Anesthesiology residency at the Long Island Jewish Medical Center in NY in 1997 and joined the faculty of the department of anesthesiology full time that year. He has served many roles in the department but primarily he created and has been the Director of the Patient Simulation Center since 2001. His research interests are in use of simulation in learning retention, optimal modalities for teaching clinical decision-making and reduction in medical errors.

 Alexis McQuitty, MD
Professor

Dr. McQuitty’s current research interest is burn cardiomyopathy, studying cardiomyopathy incidence, perioperative echocardiography for identification, and perioperative management. Her current projects include “Growth Hormone Therapy for Muscle Regeneration in Severely Burned Patients” (Shriners of North America, Branski, PI), 2016-19, and “A Method to Identify the Location of an Endotracheal Cuff Using Optoacoustics” (Shabot, PI), 2012-Present.

 Brita M. Mittal, MD
Assistant Professor

Dr. Mittal received her B.S. in Materials Science & Engineering from Massachusetts Institute of Technology, obtained her M.D. at the University of California Los Angeles, and completed both her anesthesiology residency and fellowship in Head & Neck Anesthesia and Advanced Airway Management at Stanford University. Dr. Mittal’s clinical and research interests include difficult airway management, anesthesia for patients with epidermolysis bullosa, and space medicine. She is currently investigating microgravity-induced airway changes, a key step towards understanding airway management challenges that will be faced by future astronaut crews. Dr. Mittal’s other current research includes the use advanced oxygenation techniques such as Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) to improve patient safety and outcomes during difficult airway management, laryngologic surgery, and in patients with epidermolysis bullosa.

 Beth Teegarden, MD
Associate Professor

Dr. Teegarden brings a clinical background in both anesthesiology and critical care medicine to her work on projects for the clinical diagnosis of shock, blood oxygenation, and blood flow. In particular, she has become a critical clinician member of the Department of Anesthesiology’s optoacoustic technology team, that has developed emerging technology that can accurately measure and diagnose deficits in these areas in real time, using non-invasive means. This technology has great potential to intervene in a crucial window of time for patients presenting with an uncertain diagnosis of shock, low oxygen saturation, or other critical issues in patients, potentially improving patient outcomes by allowing for more rapid, targeted response to acute injury or illness.

 3.4. Grant Funding Summaries

Support for research activities based in the Department of Anesthesiology remains relatively stable, although at a lower level that in previous years, in large part due to the ending of a large, multi-year grant from the Moody Foundation, and the abrupt cancellation of all research at UTMB funded by Shriners of North America.

Notes: Funds shown are in total costs. Award data is broken out by UTMB fiscal (FY), except in the case of DoD funding, that is awarded in an aggregate amount in the first year of the project. This results in significantly higher reported awards for DoD grants in their first years (e.g., FY 2018-20), without funds reported for those same projects in their second- or third years (e.g., FY 2021-22). FY2018 was the last year of a large, multi-year project funded by the Moody Foundation (categorized as “Private Funding”) to support multidisciplinary work on therapies for traumatic brain injury (TBI) of approximately $3M annually, that ended on December 31, 2018. Several in-progress studies funded by Shriners of North America were cancelled effective December 31, 2019 as a result of a university-wide action unrelated to the Department of Anesthesiology, but affecting all awards at UTMB.

In addition to funded projects hosted in the Department of Anesthesiology, department personnel maintain a high level of activity on projects hosted by other departments on campus, both as key personnel (i.e., Co-Investigators) or as research support staff. In FY2018-22, the total costs of these projects amounted to over $20M:

Also worthy of note is that the Department of Anesthesiology is the department of record for the recent RM1 award for NS128787, “Understanding the Mechanistic, Neurophysiological, and Antinociceptive Effects of Transcutaneous Auricular Neurostimulation for Treatment of Chronic Pain,” under the direction of Denise Wilkes, MD, PhD (Contact PI, Anesthesiology), David Houghton, PhD (UTMB Psychiatry & Behavioral Science), and Bashar Badran, PhD (Medical University of South Carolina). This project was formally awarded on September 12, 2022, with an official start date of September 15, 2022, and thus falls outside the period covered in this report. The total proposed budget for the five-year project, significant portions of which will be carried out via subaward from UTMB to other institutions, was $9,352,583. The Year 01 award was for $1,910,070 in combined direct and F&A costs.

3.6. Physical Space

Space and Facilities Available in Research Building 21

The first (ground) floor of Building 21 houses the Animal Resource Center. The Department of Anesthesiology currently occupies laboratory space on the second floor, substantial office and laboratory space on the third floor, and office and laboratory space on the fourth floor. In all, the Department of Anesthesiology utilizes about 22,000 square feet in Building 21, encompassing office space, rooms for specialized equipment, operating rooms, necropsy rooms, and housing for animals on 24/7 telemetry. Research Building 21 opened in the fall of 2008 after a years-long renovation, with much of the final design being developed in consultation with researchers from the Department of Anesthesiology and other anticipated users.

The Charles R. Allen Research Laboratories are a 2,660 ft² facility on the second floor of Research Building 21 that includes four small animal surgical and monitoring laboratories, three behavioral outcome assessment laboratories and an animal housing area used for studies of the long-term effects of TBI. The space includes four animal research laboratories equipped for aseptic surgery & monitoring, as well as three behavioral assessment laboratories equipped to evaluate the effects of TBI on memory and the effects of TBI on brain blood vessels. The Charles R. Allen Research Laboratories also occupy a small space on the second floor or Research Building 21 of about 345 ft².

The Translational Intensive Care Unit (TICU), occupying about 10,000 ft² on the second floor of Research Building 21, is designed to provide continuous intensive care to large animals (mostly sheep and pigs) subjected to various disease conditions that closely mimic life-threatening acute morbidities in humans i.e., sepsis, ALI/ARDS, polytrauma such as burn, hemorrhagic shock, spinal cord injury and traumatic brain injury. The TICU consists of a surgical suite, intensive care unit, procedure room, biosafety level-2 suite for bacterial sepsis studies, clinical lab (hematology, micro and molecular biology), autopsy unit, and a sterilization unit. The surgical suite (operation and procedure rooms) exactly mirror hospital operation rooms, enabling us to model various pathological conditions closely mimicking life-threatening human diseases.

The TICU has fully equipped intensive care stations that allow us to simultaneously monitor 24 large animals with various disease conditions for both 24 hours and longer time periods up to 4 weeks. It provides those animals with continuous intensive care 24 hours a day with 3 shifts (day, evening, and night) of highly trained laboratory personnel in a similar manner as is given in a human ICU. The animals are connected to hemodynamic monitors via various vascular catheters, including left atrium of the heart, placed on mechanical ventilators, fluid resuscitated, and treated with different experimental drugs. The animals are attended, daily, by anesthesiologists, surgeons, intensivists, internists, veterinarians, and PhDs to assess the conditions. They collect and interpret the data obtained using various diagnostic and laboratory equipment, such as blood gas analyzer, co-oximeter, coagulation analyzers, complete blood cell counter, pulmonary function test device, and other clinical laboratory devices. The TICU Director, Dr. Enkhbaatar, discusses the animal condition at daily morning rounds with all lab personnel, including doctors, nurses, scientists, and research associates. The studies performed at the TICU are highly translational. The TICU is a valuable asset not only to UTMB, but nationwide because of uniqueness in its setting and operations.

The Resuscitation Research Laboratory (RRL) occupies about 1,975 ft² on the second floor of Research Building 21. The RRL performs translational research moving concept and invention to prototypes, animal testing, human trials and commercialization. The team evaluates various resuscitation regimens using both animal models and patient studies. The RRL Engineering Division focuses on modeling and device development of software and hardware.

The Immunology Labs for the Department of Anesthesiology include office- and laboratory space on the fourth floor of Research Building 21. These include three private offices totaling about 400 ft², and immediately-adjacent laboratory space of approximately 2,130 ft².

The Department of Anesthesiology also maintains a laboratory and engineering space on the fourth floor of Research Building 21, of about 370 ft² for optoacoustical research activities.

Most research faculty in the Department of Anesthesiology have assigned, private office space on the third floor of Research Building 21 on the main UTMB campus. These offices are part of a larger office suite, where physical proximity to one another encourage regular, informal interactions and can lead to closer collaborative relationships. Individual faculty offices range in size from 105 to 192 ft². All have large, exterior windows, telephone and high-speed data connections, both cabled and via WiFi. A number of research support staff such as technical personnel, graduate students have dedicated workspaces nearby within the same office suite, making frequent mentoring, communication, and interaction easy and efficient. The total floor space dedicated to the department’s office suite on the third floor of Research Building 21 is approximately 3,350 ft², including both private offices and shared workspaces.

3.7. Future Goals, Challenges, and Approaches

As noted in the introduction to this section, the Department of Anesthesiology has an 80-year history of emphasizing its research mission – basic, translational, and clinical research – alongside its missions of providing outstanding clinical care and professional educational opportunities for medical residents, graduate students, and postdoctoral fellows. The Department of Anesthesiology will continue to focus on research in the years to come, and into its second century. We recognize, however, that substantial challenges exist that need to be mitigated.

Extramural research funding has become increasingly scarce in recent decades, as a result of greater competition for research dollars that, while increasing generally, have not kept pace with the need. This trend is compounded further by both emerging technologies that offer increasingly complex diagnostics and therapeutic interventions, and illnesses and pathologies (e.g., COVID) that were either little-considered or entirely unknown in previous years.

The Department of Anesthesiology has a solid track record focusing on areas such as burn injury and smoke inhalation, pain research, immunology, sepsis, shock and fluid resuscitation, non-invasive monitoring, and basic and translational aspects of traumatic brain injury. The Translational Intensive Care Unit (TICU), in particular, has active collaborations nationally and internationally. It is recognized as one of the very few large-animal research facilities in the United States. The TICU has unique models that closely parallel human physiology and disease, that allow studying the disease process in environments similar to pre-hospital care or the ICU over periods of hours, days and even weeks.

Challenges to expanding the Department of Anesthesiology’s current programs and developing new ones remain a critical concern. Significant requirements on research faculty appointments require a minimum level of extramural funding in order to retain the appointment. This makes it difficult for researchers, especially for early-career faculty to build the scientific foundation and mature into a career as an independent (and well-funded) investigator. The Department of Anesthesiology has offset this dilemma, in part, by encouraging clinical anesthesiologists who want to focus a significant amount of time on research to devote as much as 50% effort to research. While this provides an early career faculty with a mentor and requisite facilities, salary support is not offset. This effectively reduces their income by half, which is not a practical option for many clinicians. Finding a mechanism to bring more junior researchers into the Department of Anesthesiology and keeping them within the department long enough to establish themselves as funded researchers, continues to be at the forefront of dialog for the department and university.

Our general goal is to increase extramural funding in coming years. Toward that end, the Department of Anesthesiology will be working closely with the university to develop program(s) to attract new investigators and recruit faculty with history of extramural funding. Our five-year plan is to improve UTMB’s Department of Anesthesiology from its current position (small program) to a top 25 ranked department (medium program), as measured by the Blue Ridge Institute for Medical Research annual ranking tables, or similar index based on annual Public Health Service/NIH funding. To achieve this goal, we will work on establishing collaborative research relationships within UTMB and with other institutions by forming multi-disciplinary translational teams, with a high priority on enhancing innovation and research capabilities. We believe that this will offer pathways to recruit and retain researchers at the beginning of their careers, as they develop into fully independent researchers. We believe that this approach will enhance multidisciplinary, “umbrella” projects by combining the best expertise in multiple fields to address complex, multifaceted scientific problems.