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P Estep

Publications and source records attributed to P Estep.

Evaluation of Sex Differences in Physiologic Responses to Submaximal Cycling Under Normoxic and Hypoxic Conditions

BACKGROUND: During Lunar missions, astronauts may live and operate in conditions where altered atmospheric pressure and oxygen concentrations may result in a mildly hypoxic environment. While the compensatory hemodynamic mechanisms ensuring adequate oxygen delivery to contracting muscles during exercise in hypoxic conditions are well-studied, less research has focused on potential sex differences in the responses to hypoxia exposure during exercise. As female astronauts make up half of the Artemis astronaut corps, understanding whether physiologic responses in a hypoxic environment differ between sexes may inform recommendations for exercising safely in exploration environments. METHODS: Fourteen subjects (7M/7F) from NASA’s Exploration Atmosphere Study performed two submaximal cycle exercise trials (10 min of exercise at 40% peak aerobic capacity [VO 2 pk]) ergometer under normobaric normoxic gas (21% O 2 ) and normobaric hypoxic (18% O 2 and balanced N 2 ) conditions in randomized order. Linear mixed models with Bonferroni post hoc corrections (fixed effects: condition, sex, VO 2 pk [covariate], body mass [BM, covariate]; random effects: subject, mission) were performed to evaluate the effect of condition and sex on physiologic responses to exercise (oxygen uptake [VO 2 ], carbon dioxide production [VCO 2 ], ventilation [VE], oxygen saturation [SpO 2 ], and heart rate [HR]). RESULTS: Males were comparable to females for age (36.6±4.7 vs 36.4±9.3 yrs; p>0.05) but had greater BM (87.3±10.9 vs 64.5±7.4 kg; p<0.001) and absolute VO2pk (3.5±0.6 vs 2.4±4.7 L/min; p<0.001). Additionally, males had higher VO2 (p=0.005), VCO2 (p=0.02), and VE (p=0.01) during exercise trials, independent of condition; however, when VO 2 pk was added as a covariate, the effect of sex was no longer significant. SpO 2 was reduced during hypoxic exercise compared to the normoxic condition (p<0.001), but neither sex nor environmental condition impacted HR. CONCLUSIONS: Though most physiologic responses to submaximal, short-duration exercise between normoxia and mild hypoxia were similar, females exhibited lower VO 2 , VCO 2 , and VE during both conditions, likely driven by lower aerobic capacity. Future research is needed to determine whether similar findings result from multiday hypobaric hypoxia experienced during missions.

N C Strock↗

Considerations for Health and Performance during Surface Extravehicular Activities

BACKGROUND: NASA’s objectives for expanding human presence beyond low Earth orbit will require Extravehicular Activities (EVAs) on lunar and planetary surfaces. Given the physiological and functional demands of conducting surface EVAs in a pressurized spacesuit in reduced gravity environments, there is a possibility that crew injury and compromised physiological and/or functional performance may present. OVERVIEW: Many human health and performance knowledge gaps exist in regards to exploration EVA that require characterization to ensure safety, reliability, and mission success. To address knowledge gaps, EVA simulations in Earth-based analog environments and/or spacesuit simulators can be utilized to provide valuable insights into task-based physiologic and metabolic costs, cognitive loads, and associated operational limitations to inform future mission concepts. Physical workloads approaching 60% of maximum metabolic rates and 85% age-predicted heart rate maxima; core body temperatures approaching 100° F; and subjective responses indicating limited spare cognitive capacity via Bedford scale have been observed during ground-based exploration EVA simulations in the NASA Active Response Gravity Offload Simulator (ARGOS) and Neutral Buoyancy Lab (NBL) during simulated planetary EVAs in pressurized suits. Further, ground-based EVA analogs vary in their ability to simulate planetary EVA and resulting physical workloads. DISCUSSION: Metabolic costs, thermal burdens, functional strength, and cognitive impacts have been and must continue to be assessed in ground-based analogs to fully characterize operational demands and crew readiness levels for exploration EVA. Considerations should be given to enabling a new concept of high-tempo surface EVA operations and associated work-rest intervals, understanding human health and performance impacts of evolving commercial suit designs and capabilities, and predictive modeling and decision support capabilities to enable safe and successful EVA operations.

P Estep↗

Effects of Mild Hypobaric Hypoxia on Visual Field Impairment

INTRODUCTION: The primary objective of the Exploration Atmosphere (EA) study is to validate a new prebreathe protocol necessary before exposure to a suited hypobaric environment during extravehicular activity (EVA) from a habitat ‘exploration atmosphere’ of 56.5kPa (8.2 psia), 34% O2, 66% N2. Prebreathe protocols must be time and resource efficient while also controlling Decompression Sickness (DCS) risk to within acceptable limits. The habitat hypobaric exploration atmosphere also results in a mildly hypoxic environment (piO2 = 128mmHg). As a secondary objective of the EA study, we characterized the effects of 11-day exposure to a mild hypobaric hypoxic environment on visual performance. METHODS: Two, 11-day hypobaric chamber tests were performed (EA-1and EA-2, n=8 each) in NASA’s 20-foot chamber at Johnson Space Center where subjects lived in the exploration atmosphere. Subjects also underwent simulated 6-hour EVAs at 85% O2 and 29.6 kPa during EVA on days 3, 5, 7, 9, and 11. Visual acuity (VA), a measure of spatial resolution, and contrast sensitivity (CS), a measure of ability to distinguish ever finer increments of brightness, were assessed on non-EVA days by using gapped Landolt C testing. The luminance was controlled by using a booth, a light monitor, and a lighting rheostat. EA-1 data had revealed problems in lighting control impacting consistency of the data. Procedures were subsequently updated for the EA-2 test. RESULTS: EA-1 data revealed large variance and data recording errors and was removed from the analysis. One participant left the study at Test Day 3 during EA-2. EA-2 ANOVA results showed CS (mean change=0.010 logCSWeber) and VA (mean change, -0.016 logMAR) between pre-test and 11-day test phases; however, neither VA nor CS changes were statistically significant. There were non-statistically significant declines in VA across test phases. DISCUSSION: Overall, visual field performance did not exhibit clinically significant changes (3 lines or greater change in LogMar chart) during exposure to the mild hypoxic exploration atmosphere environment compared to pre-test baseline. The consistency and stability of VA data during EA-2 suggests that the mild hypobaric hypoxic environment did not cause clinically significant negative impacts to participants’ visual field performance.

Visual Acuity↗

Considerations for Health and Performance During Surface Extravehicular Activities

BACKGROUND: NASA’s objectives for expanding human presence beyond low Earth orbit will require Extravehicular Activities (EVAs) on lunar and planetary surfaces. Given the physiological and functional demands of conducting surface EVAs in a pressurized spacesuit in reduced gravity environments, there is a possibility that crew injury and compromised physiological and/or functional performance may present. OVERVIEW: Many human health and performance knowledge gaps exist in regards to exploration EVA that require characterization to ensure safety, reliability, and mission success. To address knowledge gaps, EVA simulations in Earth-based analog environments and/or spacesuit simulators can be utilized to provide valuable insights into task-based physiologic and metabolic costs, cognitive loads, and associated operational limitations to inform future mission concepts. Physical workloads approaching 60% of maximum metabolic rates and 85% age-predicted heart rate maxima; core body temperatures approaching 100o F; and subjective responses indicating limited spare cognitive capacity via Bedford scale have been observed during ground-based exploration EVA simulations in the NASA Active Response Gravity Offload Simulator (ARGOS) and Neutral Buoyancy Lab (NBL) during simulated planetary EVAs in pressurized suits. Further, ground-based EVA analogs vary in their ability to simulate planetary EVA and resulting physical workloads. DISCUSSION: Metabolic costs, thermal burdens, functional strength, and cognitive impacts have been and must continue to be assessed in ground-based analogs to fully characterize operational demands and crew readiness levels for exploration EVA. Considerations should be given to enabling a new concept of high-tempo surface EVA operations and associated work-rest intervals, understanding human health and performance impacts of evolving commercial suit designs and capabilities, and predictive modeling and decision support capabilities to enable safe and successful EVA operations.

EVA↗

Development, Validation and Approval of A Planetary Extravehicular Activity Prebreathe Protocol: NASA Exploration Atmosphere Tests 1 & 2

INTRODUCTION: Denitrogenation prebreathe protocols used to mitigate DCS risk for Space Shuttle and International Space Station EVAs are validated for the microgravity environment, but the significantly increased risk of DCS during equivalent ambulatory surface EVAs make these protocols inapplicable to planetary/Lunar missions as planned by the Artemis program. Living in an “Exploration Atmosphere” of 56.5 kPa (8.2 psia), 34% O2, 66% N2 has been recommended by NASA for future Moon and Mars missions as a compromise that balances pre-EVA prebreathe duration, hypoxia, and flammability risk, assuming a 29.6 kPa (4.3 psi) spacesuit. A prebreathe validation campaign at NASA’s Johnson Space Center in 2022–2023 has aimed to validate the prebreathe durations and is being operationalized by NASA for use in upcoming Lunar EVAs. METHODS: Twelve volunteers lived in a hyboparic chamber for 11 days with an “exploration atmosphere” of 56.6kPa/34% O2 66% N2. Subjects acclimated to this atmosphere for 48 hrs and thereafter participated in five 6-hour simulated EVAs at 34kPa/85% O2 / 15% N2 over the course of 11 days. Prior to each simulated EVA, subjects underwent a 20-minute prebreathe at 85% O2. The EVA simulation was designed to include tasks that are physically and ergonomically representative of future planetary EVAs, proportionate to the subject’s VO2max. Decompression stress was evaluated during the simulated EVA by serial doppler and echocardiographs alternating every 15 min, as well as clinical monitoring for DCS signs/symptoms. Venous gas emboli (VGE) and DCS outcomes were verified against NASA Standard 3001, which guides allowable prebreathe protocol acceptance criteria. RESULTS AND DISCUSSION: Venous gas emboli (VGE) were identified during EVAs. No Grade IV VGE were observed. Two cases of mild, Type I DCS were identified in the subjects over the course of 50 EVA exposures. Ten planned EVA exposures were eliminated due to mask fit, metabolic rate, or subject safety concerns. One subject was removed from the study due to presence of left ventricular VGE. Additionally, two doppler techs also experienced DCS, and one case of hypoxia was noted. All cases of DCS resolved with treatment. No cases of severe DCS were observed. The observed incidence (4%, 1.1–13.5% at 95% confidence) met the NASA Standard 3001 criteria leading to the transition of this protocol from research to operational use for upcoming Lunar missions.

Exploration Atmosphere↗

Effects of Mild Hypobaric Hypoxia on Response From Mild Exercise in NASA Exploration Atmosphere Tests

INTRODUCTION: The NASA Exploration Atmosphere study aims to validate a new prebreathe protocol incorporating an alternate habitat atmosphere of 56.5 kPa (8.2psia), 34% O 2 , and 66% N 2 to control and mitigate decompression sickness risk associated with spaceflight extravehicular activities. This alternate atmosphere results in a mild hypoxic environment (PIO 2 of 128 mmHg) that may influence inhabitant physiological responses to exercise. Therefore, the responses to light exercise in relation to the mild hypobaric hypoxic environment were investigated. METHODS: Eight participants (4M/4F; age=38.3±9.0 yr; weight=76.0±13.1 kg; peak aerobic capacity [VO 2 pk]= 3.1±0.7 L/min) were exposed to a mild hypobaric hypoxic environment for 11 days in NASA’s 20-foot hypobaric chamber at Johnson Space Center. Participants alternated test days between a habitat atmosphere of 56.5 kPA/34% O 2 and simulated 6-hour EVA environment, 29.6 kPa/85% O 2 . Participants completed pre-mission graded VO 2 pk tests on a LODE cycle ergometer with ParvoMedics metabolic analyzer. Submaximal aerobic tests were performed pre and during the mission (10-minutes of exercise at a workload of 40% VO 2 pk).Pre-mission, performed submaximal exercise exposed to a breathing air mixture of, 18% O 2 and balance N 2 , to simulate the mildly hypoxic environment within the 20-foot chamber. Linear mixed models (fixed effect: test day; random effects: subject, age) were performed to determine whether physiological responses (oxygen uptake [VO 2 ], carbon dioxide production [VCO 2 ], ventilation [VE], oxygen saturation [SPO 2 ], heart rate [HR], respiratory exchange ratio [RER]) to submaximal exercise performed within the 20-foot hypobaric chamber every 2 days differed from the pre-mission (18% O 2 ) testing. Results are presented as estimated marginal means with lower and upper confidence limits, with significance set to 0.05. RESULTS AND DISCUSSION: Seven of eight participants completed the chamber study. Mixed models for VO 2 , VCO 2 , SpO 2 , HR, and RER indicated negligible impact of the mild hypoxic chamber environment compared to pre-mission testing (all p>0.05).Results for VE indicated a minor impact of chamber environment compared to pre-mission testing (37.0 L/min [30.8, 43.2]), with increased VE at test day 10 (40.4 L/min [34.2, 46.6]; p= 0.029).The aerobic performance data collected suggests limited physiologic responses to mild exercise when performed at normobaric hypoxia and hypobaric hypoxia.

B Siders↗

Nasa Exploration Atmosphere Tests 3 & 4: Development and Validation of Planetary Extravehicular Activity Prebreathe Protocols for Alternate Atmospheres and Suit Pressures

INTRODUCTION: Space suits operate at low pressures to optimize astronauts’ performance. The drop in pressure from the habitat environment to the suit carries a risk of decompression sickness (DCS), which is mitigated by a 95% O2 prebreathe protocol. Prebreathe protocols for the lunar surface have a significantly higher risk compared to International Space Station microgravity Extravehicular Activities (EVA). In previous studies, we validated a prebreathe protocol from a 56.5 kPa 34% O2 cabin to a 29.6 kPa EVA pressure; however, the enriched oxygen cabin environment poses a flammability risk that requires significant changes to material design and selections. Here, we report outcomes for prebreathe protocols from a sub-30% O2 cabin and associated changes necessary to control DCS risk critical to upcoming lunar missions. METHODS: Fourteen volunteers completed 11-day hypobaric chamber studies with an “alternate exploration atmosphere” of 66.2kPa, 28.5% O2. Subjects acclimated for 48 hrs and then participated in five 6-hour simulated EVAs at 29.6 or 35.6kPa, 95% O2. Prior to EVA, subjects underwent a 20, 90, or 150-minute prebreathe. The EVA simulation was designed to be representative of future planetary EVAs, proportionate to the subject’s VO2max. Decompression stress was monitored by real-time doppler and echocardiograph alternating every 15 min, as well as clinical monitoring for DCS signs/symptoms. Venous gas emboli (VGE) and DCS outcomes were verified against NASA-STD-3001 acceptance criteria. RESULTS AND DISCUSSION: Venous gas emboli (VGE) were identified during all EVAs. A neurological DCS case was identified in the 90-min/29.6kPa prebreathe, terminating further testing of this protocol. No DCS cases were identified in the 150 min/29.6kPa protocol. The 20 min/36.5kPa protocol was rejected due to a Type II DCS case. All DCS symptoms resolved with treatment, with no sequelae post initial treatment of DCS. These various test points highlighted to the significant benefit of elevated suit pressure to shorten prebreathe protocols, but also the difficulty in assessing and managing DCS during sustained EVA operations in remote planetary surfaces.

decompression sickness↗