Space Medicine Capabilities and Challenges for Exploration Missions
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Engineering topics
Publications and source records attributed to Moriah S Thompson.
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Cardiovascular disease (CVD) is associated with high doses of radiation and is are cognized health risk for astronauts on multiple or long duration exploration missions to the Moon or Mars. Currently, radiation risk assessment is based on background population disease rates and does not consider individual risk factors that may modify analysis, especially at lower radiation doses.
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INTRODUCTION: The ability to create intravenous fluids (IVF) in-situ from the potable water supply of a spaceflight vehicle or habitat is a desired capability for an exploration medical system. In order to define an acceptable volume of air in IVF bags, an understanding of the volume of venous gas embolism as it relates to negative outcomes is needed. The purpose of this study is to review the literature to determine if there is a known volume of gas that contributes to mortality and/or morbidity that could be used to define requirements for rapid IVF infusion in microgravity. METHODS: A literature review was conducted of the PubMed database using the syntax: (Venous) AND (Gas OR Air) AND (Embolism) AND (Morbidity) AND (Mortality) AND (Volume) as well as manual review of references from relevant articles. 151 articles were screened excluding partial text and pediatric articles. Studies were reviewed for identification of volume of venous gas embolism associated with morbidity and/or mortality, which identified 27 articles. RESULTS: Reviewed literature included animal studies, case reports, and review articles. A high variation of proposed volumes contributing to mortality was reported. The limited human data values ranged from 20 ml to 200 ml of infused air with mortality estimated to be 48 – 80%. No studies evaluated human morbidity in any capacity. DISCUSSION: The lack of consensus on the safe volume of infused air has potential ramifications for IVF use in spaceflight as current technologies to create IVF from potable water may introduce air in IVF bags. While current microgravity infusion protocols call for the use of inline air removal filters, commercially available options have flow rate limitations that preclude rapid infusion in a resuscitation scenario. Such filters may be used in parallel to increase flow rate, but the time required to set up such a system may exclude its use during a medical emergency. Additionally, these consumable filters drive up the overall mass and volume of the medical system. Identification of a safe volume of air in IVF would allow for guidelines for the in-situ production of IVF in future spaceflight vehicles/habitats.
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NASA has identified twenty-eight specific risks to human health and performance that must be adequately understood and addressed to enable future crewed missions to Mars. These risks are due to radiation, reduced gravity, distance from earth, isolation and confinement, and the effects of living within artificially created and controlled life support environments. Research and technology development is required to better understand these risks and to inform, develop, and test technologies and strategies to mitigate these risks. NASA’s System Capability Leads coordinate across the agency to continually identify, prioritize, and monitor technology investments in support of these future missions. This paper describes progress over the past year in strategic planning, coordination, and technology development related to crew health and performance capabilities that are needed for future Mars missions. Technology maturation progress and future plans are described in the following capability areas: crew health countermeasures; spacesuit physiology and performance; food and nutrition; and exploration medical capabilities.