Richard E. Moon, MD, CM, MSc, FRCP, FACP, FCCP
Principal Investigator
Professor of Anesthesiology
Medical Director, Hyperbaric Center
Professor of Medicine

Contac Us

Duke Center For Hyperbaric Medicine & Environmental Physiology
Trent Dr., Building CR2 Room 0584
DUMC 3823
Durham, NC 27710

Appointments
919-684-6726

Emergency
919-684-8111

Email
richard.moon@duke.edu

Lab Description

Study being performed at the FG Hall Environmental Lab

Studying physiological responses to high and low ambient pressures, exercise and altered temperatures can be used to improve the performance of divers and climbers, but also provide insight into the response to stress in clinical medicine. The FG Hall Environmental Laboratory contains a seven-chamber 254 cu m chamber complex that can simulate diving and altitude. This unique complex is the largest civilian environmental facility in the country. The chambers can be compressed to 110 atmospheres (3,600 feet of sea water) and decompressed to simulate altitude exposure to 100,000 feet. A surface exercise laboratory provides measurement of maximum oxygen uptake and ventilatory chemosensitivity. Measurement of blood gases, lactate and hemoglobin can be performed at the surface and inside the chamber. Mass spectrometry provides on-line measurement of mixed expired and end-tidal carbon dioxide and oxygen, with lab based gas chromatography. A temperature-controlled pool is available for head-out immersed or fully submersed exercise. Transthoracic echocardiography can be performed during immersed exercise. Human studies can be performed at altitude or depth with invasive measurement of arterial and pulmonary arterial pressures, transcranial Doppler blood velocity, precordial Doppler monitoring for vascular bubbles, EEG and in vivo near infrared spectroscopy. Also on the premises is an exercise testing facility. Dr. Piantadosi’s laboratory is adjacent, and can process tissue specimens for analysis of histology, molecular pathway markers and activity, and gene expression and activation. An electronics shop and machine shop provide in-house design and construction facilities. The FG Hall Laboratory is within Duke Medical Center, with access to hospital labs, radiology and MR imaging.

Lab Members

Medical Instructor in the Department of Medicine
Associate Professor of Anesthesiology
Assistant Professor of Anesthesiology
Assistant Professor of Emergency Medicine
Associate Professor in Anesthesiology
Professor with Tenure in the Thomas Lord Department of Mechanical Engineering and Materials Science
Associate Professor Emeritus in Surgery
Professor Emeritus of Medicine
Assistant Professor of Anesthesiology

Research Support

Robert Brown
Owen Doar
Alexis Drake
Alan Gatrell
Tom De Hoog

Debbie Kraft
Matt McDorman
Mike Natoli (Lab Manager)
Dan Nord
Aashay Patel

Zach Ransom
Kieran Sariego
Eric Schinazi
Aaron Walker
Mark Wright

Staff Assistant 

Tonya Manning

Recent Publications

  1. Suliman HB, Keenan JE, Piantadosi CA. Mitochondrial quality-control dysregulation in conditional HO-1-/- mice. JCI Insight. 2017 Feb 9;2(3):e89676.
  2. Piantadosi CA, Suliman HB. Mitochondrial Dysfunction in Lung Pathogenesis.  Annu Rev Physiol. 2017 Feb 10;79:495-515.
  3. Demchenko IT, Zhilyaev SY, Moskvin AN, Krivchenko AI, Piantadosi CA, Allen BW. Antiepileptic drugs prevent seizures in hyperbaric oxygen: A novel model of epileptiform activity.  Brain Res. 2017 Feb 15;1657:347-354.
  4. Bennett-Guerrero E, Lockhart EL, Bandarenko N, Campbell ML, Natoli MJ, Jamnik VK, Carter TR, Moon RE. A randomized controlled pilot study of VO2 max testing: a potential model for measuring relative in vivo efficacy of different red blood cell products.  Transfusion. 2017 Mar;57(3):630-636.
  5. Ghanta S, Tsoyi K, Liu X, Nakahira K, Ith B, Coronata AA, Fredenburgh LE, Englert JA, Piantadosi CA, Choi AM, Perrella MA. Mesenchymal Stromal Cells Deficient in Autophagy Proteins Are Susceptible to Oxidative Injury and Mitochondrial Dysfunction.  Am J Respir Cell Mol Biol. 2017 Mar;56(3):300-309.
  6. Moon RE. Spontaneous Absorption of Cerebral Air Emboli.  J Cerebrovasc Endovasc Neurosurg. 2017 Mar;19(1):52-53.
  7. Hampson NB, Moon RE, Weaver LK. Another perspective on ACEP policy on critical issues in carbon monoxide poisoning: Invited commentary.  Undersea Hyperb Med. 2017 Mar-Apr;44(2):89-92.
  8. Gulack BC, Hale B, White WD, Moon RE, Bennett-Guerrero E. Marriage and mortality after noncardiac surgery.  J Surg Res. 2017 Apr;210:152-158.
  9. Dunworth SA, Natoli MJ, Cooter M, Cherry AD, Peacher DF, Potter JF, Wester TE, Freiberger JJ, Moon RE. Hypercapnia in diving: a review of CO₂ retention in submersed exercise at depth.  Undersea Hyperb Med. 2017 May-Jun;44(3):191-209.
  10. Calabrese E, Ceponis PJ, Derrick BJ, Moon RE. Successful treatment of pneumatosis intestinalis with associated pneumoperitoneum and ileus with hyperbaric oxygen therapy.  BMJ Case Rep. 2017 May 30;2017:bcr2017219209.
  11. Gasier HG, Demchenko IT, Tatro LG, Piantadosi CA. S-nitrosylation of GAD65 is implicated in decreased GAD activity and oxygen-induced seizures.  Neurosci Lett. 2017 Jul 13;653:283-287.
  12. Lance RM, Stalcup L, Wojtylak B, Bass CR. Air blast injuries killed the crew of the submarine H.L. Hunley.  PLoS One. 2017 Aug 23;12(8):e0182244.
  13. Grünig H, Nikolaidis PT, Moon RE, Knechtle B. Diagnosis of Swimming Induced Pulmonary Edema-A Review.  Front Physiol. 2017 Aug 31;8:652.
  14. Martina SD, Freiberger JJ, Peacher DF, Natoli MJ, Schinazi EA, Kernagis DN, Potter JVF, Otteni CE, Moon RE. Sildenafil: Possible Prophylaxis against Swimming-induced Pulmonary Edema.  Med Sci Sports Exerc. 2017 Sep;49(9):1755-1757.
  15. Strand TE, Khiabani HZ, Boico A, Radiloff D, Zhao Y, Hamilton KL, Christians U, Klawitter J, Noveck RJ, Piantadosi CA, Bell C, Irwin D, Schroeder T. The novel combination of theophylline and bambuterol as a potential treatment of hypoxemia in humans.  Can J Physiol Pharmacol. 2017 Sep;95(9):1009-1018.
  16. Suliman HB, Kraft B, Bartz R, Chen L, Welty-Wolf KE, Piantadosi CA. Mitochondrial quality control in alveolar epithelial cells damaged by S. aureus pneumonia in mice.  Am J Physiol Lung Cell Mol Physiol. 2017 Oct 1;313(4):L699-L709.
  17. Lance RM, Natoli MJ, Dunworth SAS, Freiberger JJ, Moon RE. The Dewey monitor: Pulse oximetry can independently detect hypoxia in a rebreather diver.  Undersea Hyperb Med. 2017 Nov-Dec;44(6):569-580.
  18. Shadrin IY, Allen BW, Qian Y, Jackman CP, Carlson AL, Juhas ME, Bursac N. Cardiopatch platform enables maturation and scale-up of human pluripotent stem cell-derived engineered heart tissues.  Nat Commun. 2017 Nov 28;8(1):1825.
  19. Lechner M, Sutton L, Fishman JM, Kaylie DM, Moon RE, Masterson L, Klingmann C, Birchall MA, Lund VJ, Rubin JS. Otorhinolaryngology and Diving-Part 1: Otorhinolaryngological Hazards Related to Compressed Gas Scuba Diving: A Review.  JAMA Otolaryngol Head Neck Surg. 2018 Mar 1;144(3):252-258.
  20. Lechner M, Sutton L, Fishman JM, Kaylie DM, Moon RE, Masterson L, Klingmann C, Birchall MA, Lund VJ, Rubin JS. Otorhinolaryngology and Diving-Part 2: Otorhinolaryngological Fitness for Compressed Gas Scuba Diving: A Review.  JAMA Otolaryngol Head Neck Surg. 2018 Mar 1;144(3):259-263.
  21. Moon RE, Hampson NB. Efficacy of Hyperbaric Oxygen for Carbon Monoxide Poisoning.  Chest. 2018 Mar;153(3):764.
  22. Villela MA, Dunworth S, Harlan NP, Moon RE. Can my patient dive after a first episode of primary spontaneous pneumothorax? A systematic review of the literature.  Undersea Hyperb Med. 2018 Mar-Apr;45(2):199-208.
  23. Lin L, Xu C, Carraway MS, Piantadosi CA, Whorton AR, Li S. RhoA inactivation by S-nitrosylation regulates vascular smooth muscle contractive signaling.  Nitric Oxide. 2018 Apr 1;74:56-64.
  24. Zapol WM, Charles HC, Martin AR, Sá RC, Yu B, Ichinose F, MacIntyre N, Mammarappallil J, Moon R, Chen JZ, Geier ET, Darquenne C, Prisk GK, Katz I. Pulmonary Delivery of Therapeutic and Diagnostic Gases.  J Aerosol Med Pulm Drug Deliv. 2018 Apr;31(2):78-87.
  25. Schroeder T, Piantadosi CA, Natoli MJ, Autmizguine J, Cohen-Wolkowieczs M, Hamilton KL, Bell C, Klawitter J, Christians U, Irwin DC, Noveck RJ. Safety and Ergogenic Properties of Combined Aminophylline and Ambrisentan in Hypoxia.  Clin Pharmacol Ther. 2018 May;103(5):888-898.
  26. Gasier HG, Demchenko IT, Zhilyaev SY, Moskvin AN, Krivchenko AI, Piantadosi CA. Adrenoceptor blockade modifies regional cerebral blood flow responses to hyperbaric hyperoxia: Protection against CNS oxygen toxicity.  J Appl Physiol (1985). 2018 Jul 19.
  27. Reynolds JD, Jenkins T, Matto F, Nazemian R, Farhan O, Morris N, Longphre JM, Hess DT, Moon RE, Piantadosi CA, Stamler JS. Pharmacologic Targeting of Red Blood Cells to Improve Tissue Oxygenation.  Clin Pharmacol Ther. 2018 Sep;104(3):553-563.
  28. Bosco G, Rizzato A, Martani L, Schiavo S, Talamonti E, Garetto G, Paganini M, Camporesi EM, Moon RE. Arterial Blood Gas Analysis in Breath-Hold Divers at Depth.  Front Physiol. 2018 Nov 5;9:1558.
  29. Fox WC, Moon RE. Blue Vision (Cyanopsia) Associated With TURP Syndrome: A Case Report.  A A Pract. 2018 Nov 15;11(10):279-281.
  30. Fredenburgh LE, Perrella MA, Barragan-Bradford D, Hess DR, Peters E, Welty-Wolf KE, Kraft BD, Harris RS, Maurer R, Nakahira K, Oromendia C, Davies JD, Higuera A, Schiffer KT, Englert JA, Dieffenbach PB, Berlin DA, Lagambina S, Bouthot M, Sullivan AI, Nuccio PF, Kone MT, Malik MJ, Porras MAP, Finkelsztein E, Winkler T, Hurwitz S, Serhan CN, Piantadosi CA, Baron RM, Thompson BT, Choi AM. A phase I trial of low-dose inhaled carbon monoxide in sepsis-induced ARDS.  JCI Insight. 2018 Dec 6;3(23):e124039.
  31. Moon RE. Immersion pulmonary edema: drowning from the inside.  Undersea Hyperb Med. 2019 Sep - Dec - Fourth Quarter;46(5):577-579.
  32. Moon RE. Hyperbaric treatment of air or gas embolism: current recommendations.  Undersea Hyperb Med. 2019 Sep - Dec - Fourth Quarter;46(5):673-683.
  33. Moon RE, Mitchell S. Hyperbaric treatment for decompression sickness: current recommendations.  Undersea Hyperb Med. 2019 Sep - Dec - Fourth Quarter;46(5):685-693.
  34. Khatri A, Kraft BD, Tata PR, Randell SH, Piantadosi CA, Pendergast AM. ABL kinase inhibition promotes lung regeneration through expansion of an SCGB1A1+ SPC+ cell population following bacterial pneumonia.  Proc Natl Acad Sci U S A. 2019 Jan 29;116(5):1603-1612.
  35. Ma Z, Yu YR, Badea CT, Kovacs JJ, Xiong X, Comhair S, Piantadosi CA, Rajagopal S. Vascular Endothelial Growth Factor Receptor 3 Regulates Endothelial Function Through β-Arrestin 1.  Circulation. 2019 Mar 26;139(13):1629-1642.
  36. Abou-Donia MB, Suliman HB, Siniscalco D, Antonucci N, ElKafrawy P. De novo Blood Biomarkers in Autism: Autoantibodies against Neuronal and Glial Proteins.  Behav Sci (Basel). 2019 Apr 29;9(5):47.
  37. Kraft BD, Chen L, Suliman HB, Piantadosi CA, Welty-Wolf KE. Peripheral Blood Mononuclear Cells Demonstrate Mitochondrial Damage Clearance During Sepsis.  Crit Care Med. 2019 May;47(5):651-658.
  38. Suliman HB, Nozik-Grayck E. Mitochondrial Dysfunction: Metabolic Drivers of Pulmonary Hypertension.  Antioxid Redox Signal. 2019 Oct 20;31(12):843-857.
  39. Demchenko IT, Zhilyaev SY, Alekseeva OS, Krivchenko AI, Piantadosi CA, Gasier HG. Increased Antiseizure Effectiveness with Tiagabine Combined with Sodium Channel Antagonists in Mice Exposed to Hyperbaric Oxygen.  Neurotox Res. 2019 Nov;36(4):788-795.
  40. Moon RE, Weaver LK. Hyperbaric oxygen as a treatment for COVID-19 infection?  Undersea Hyperb Med. 2020 Second-Quarter;47(2):177-179.
  41. Bosco G, Paganini M, Rizzato A, Martani L, Garetto G, Lion J, Camporesi EM, Moon RE. Arterial blood gases in divers at surface after prolonged breath-hold.  Eur J Appl Physiol. 2020 Feb;120(2):505-512.
  42. Yu YA, Malakhau Y, Yu CA, Phelan SJ, Cumming RI, Kan MJ, Mao L, Rajagopal S, Piantadosi CA, Gunn MD. Nonclassical Monocytes Sense Hypoxia, Regulate Pulmonary Vascular Remodeling, and Promote Pulmonary Hypertension.  J Immunol. 2020 Mar 15;204(6):1474-1485.
  43. Gasier HG, Yu T, Swift JM, Metzger CE, McNerny EM, Swallow EA, Piantadosi CA, Allen MR. Carbon Monoxide and Exercise Prevents Diet-Induced Obesity and Metabolic Dysregulation Without Affecting Bone.  Obesity (Silver Spring). 2020 May;28(5):924-931.
  44. Piantadosi CA. Mitochondrial DNA, oxidants, and innate immunity.  Free Radic Biol Med. 2020 May 20;152:455-461.
  45. Dong TW, MacLeod DB, Santoro A, Augustine Z, Barth S, Cooter M, Moon RE. A methodology to explore ventilatory chemosensitivity and opioid-induced respiratory depression risk.  J Appl Physiol (1985). 2020 Sep 1;129(3):500-507.
  46. Hampson NB, Moon RE. Arterial gas embolism breathing compressed air in 1.2 metres of water.  Diving Hyperb Med. 2020 Sep 30;50(3):292-294.
  47. Moon RE. Central nervous system oxygen toxicity during 100% oxygen breathing at normobaric pressure.  Diving Hyperb Med. 2020 Sep 30;50(3):306.
  48. Gasier HG, Dohl J, Suliman HB, Piantadosi CA, Yu T. Skeletal muscle mitochondrial fragmentation and impaired bioenergetics from nutrient overload are prevented by carbon monoxide.  Am J Physiol Cell Physiol. 2020 Oct 1;319(4):C746-C756.
  49. Moon RE, Beck TP. Cold Water, Hard Swim, Shortness of Breath: How to Assess?  Chest. 2020 Oct;158(4):1329-1330.
  50. Dong TW, MacLeod DB, Santoro A, Augustine Z, Barth S, Cooter M, Moon RE. Reply to Drs. Wang et al.  J Appl Physiol (1985). 2020 Oct 1;129(4):933.
  51. Moon RE. Hyperoxia-induced brain ischemia: the Strawman comes up short.  Can J Anaesth. 2021 Jan;68(1):150-151.
  52. Feldmeier JJ, Kirby JP, Buckey JC, Denham DW, Evangelista JS, Gelly HB, Harlan NP, Mirza ZK, Ray KL, Robins M, Savaser DJ, Wainwright S, Bird N, Huang ET, Moon RE, Thom SR, Weaver LK. Physiologic and biochemical rationale for treating COVID-19 patients with hyperbaric oxygen.  Undersea Hyperb Med. 2021 First-Quarter;48(1):1-12.
  53. Le DQ, Dayton PA, Tillmans F, Freiberger JJ, Moon RE, Denoble P, Papadopoulou V. Ultrasound in decompression research: fundamentals, considerations, and future technologies.  Undersea Hyperb Med. 2021 First-Quarter;48(1):59-72.
  54. Markley E, Le DQ, Germonpré P, Balestra C, Tillmans F, Denoble P, Freiberger JJ, Moon RE, Dayton PA, Papadopoulou V. A fully automated method for late ventricular diastole frame selection in post-dive echocardiography without ECG gating.  Undersea Hyperb Med. 2021 First-Quarter;48(1):73-80.
  55. Tomoye EO, Moon RE. Hyperbaric oxygen for intracranial abscess.  Undersea Hyperb Med. 2021 First-Quarter;48(1):97-102.
  56. Moon RE, Mitchell SJ. Hyperbaric oxygen for decompression sickness.  Undersea Hyperb Med. 2021 Second-Quarter;48(2):195-203.
  57. Bennett-Guerrero E, Rizwan S, Rozensky R, Romeiser JL, Brittelli J, Makaryus R, Lin J, Galanakis DK, Triulzi DJ, Moon RE. Randomized controlled trial of 7, 28, vs 42 day stored red blood cell transfusion on oxygen delivery (VO2 max) and exercise duration.  Transfusion. 2021 Mar;61(3):699-707.
  58. Kraft BD, Mahmood K, Harlan NP, Hartwig MG, Snyder LD, Suliman HB, Shofer SL. Hyperbaric oxygen therapy to prevent central airway stenosis after lung transplantation.  J Heart Lung Transplant. 2021 Apr;40(4):269-278.
  59. Sergot PB, Maza AJ, Derrick BJ, Smith LM, Berti LT, Wilcox MR, Kesinger MR, Peacock WF; EDGAR Study Group. Portable Neuromonitoring Device Detects Large Vessel Occlusion in Suspected Acute Ischemic Stroke.  Stroke. 2021 Apr;52(4):1437-1440.
  60. Stein JA, Gasier HG, Goodman BD, Ramirez MR, Delatorre BP, Beattie CM, Barstow TJ, Heinrich KM. Effects of Caffeine on Exercise Duration, Critical Velocity, and Ratings of Perceived Exertion During Repeated-Sprint Exercise in Physically Active Men.  Int J Exerc Sci. 2021 Apr 1;14(2):435-445. eCollection 2021.
  61. Chen L, Kraft BD, Roggli VL, Healy ZR, Woods CW, Tsalik EL, Ginsburg GS, Murdoch DM, Suliman HB, Piantadosi CA, Welty-Wolf KE. Heparin-based blood purification attenuates organ injury in baboons with Streptococcus pneumoniae pneumonia.  Am J Physiol Lung Cell Mol Physiol. 2021 Aug 1;321(2):L321-L335.
  62. Scott JM, Swallow EA, Metzger CE, Kohler R, Wallace JM, Stacy AJ, Allen MR, Gasier HG. Iron deficiency and high-intensity running interval training do not impact femoral or tibial bone in young female rats.  Br J Nutr. 2021 Nov 11:1-8.
  63. Suliman HB, Healy Z, Zobi F, Kraft BD, Welty-Wolf K, Smith J, Barkauskas C, Piantadosi CA. Nuclear respiratory factor-1 negatively regulates TGF-β1 and attenuates pulmonary fibrosis.  iScience. 2021 Dec 1;25(1):103535.
  64. Covington DB, Moon RE. Anesthesia and Surgery in Space: Comment.  Anesthesiology. 2022 Feb 1;136(2):399.
  65. Paganini M, Moon RE, Boccalon N, Melloni GEM, Giacon TA, Camporesi EM, Bosco G. Blood gas analyses in hyperbaric and underwater environments: a systematic review.  J Appl Physiol (1985). 2022 Feb 1;132(2):283-293.
  66. Lance RM, Natoli MJ, Di Pumpo F, Beck TP, Gatrell A, Brown GJ, Schocken D, Moon RE. The Dewey Monitor: Pulse Oximetry can Warn of Hypoxia in an Immersed Rebreather Diver in Multiple Scenarios.  Ann Biomed Eng. 2022 Feb;50(2):222-232.
  67. Beck TP, Tsipis N, Kisslo JA, Rivera JD, Armour AC, Moon RE. Immersion-induced mitral regurgitation: a novel risk factor for swimming-induced pulmonary edema. Chest 2022 (in press).

Photos

Submersion Study
Hyperbaric Breathing Study
Riociguat at Study Monitors
Immersed Echo Study
Collage of Hyperbaric Studies