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Rahul Suresh

Publications and source records attributed to Rahul Suresh.

At least 19 records
All sourcesNASA NTRSDOE OSTI
NASA NTRS2024

Crew Health and Performance Integrated Data Architecture (CHP-IDA) TechPort May 2024

Future exploration missions to Mars will have increased need for crew autonomy. Crew Health & Performance (CHP) related data on the ISS is currently, manually downlinked and in disparate locations, which limits crew autonomy for future missions. The CHP-IDA project is developing a backend data system platform that grants the ability to seamlessly collect, store, process, and display CHP-related data for exploration missions. This platform allows for integration of data and advanced analytics that offer crew and ground teams better insight into the crew’s health and performance. It also enables applications that can improve the crew’s ability to provide more autonomous medical care during exploration missions. Data will be collected automatically to reduce crew and ground team time and effort and will synchronize across all in-mission vehicles, habitats, and ground as communication delay permits. The Human Research Program’s (HRP) Medical Data Architecture (MDA) project focused on this backend data architecture but for medical data only. The CHP-IDA project, a joint effort between HRP’s Exploration Medical Capability (ExMC) element and the Exploration Medical Integrated Product Team (XMIPT), expands this capability to all relevant CHP-related data. The additional inputs from nutrition, environment, exercise, radiation, and any other relevant sources will give more insight into crew’s health and performance. Currently, the Human Systems Engineering and Integration Division at Johnson Space Center (JSC) is designing the system. The team completed a system requirements review (SRR) in FY22 and now the focus is on core software development, testbed buildup, and use case scenario demonstration. An end-to-end demonstration with multiple data sources across CHP domains is schedule for the end of FY24 where all three focus areas will be displayed. Following this ground demo, the software will be completed, tested, and validated for flight.

Courtney M Schkurko↗
NASA NTRS2024

IVGen Mini Techport May 2024

Intravenous (IV) fluids are an important treatment modality for multiple medical conditions that have the potential to occur during Mars missions and that may lead to adverse crew health and mission outcomes without appropriate treatment. However, carrying sufficient volumes of IV fluids with adequate shelf life to support such missions is currently not feasible due to anticipated mass and volume constraints of future vehicles and the relatively short shelf-life of terrestrial IV fluids. The goal of the IntraVenous Fluid Generation for Exploration Missions, Miniaturized, (IVGen Mini) project is to develop a low mass and volume IV fluid generation device that can produce IV fluids in situ and that reduces the need to launch and store large quantities of IV fluids. It builds on the original IVGEN system developed by the Human Research Program’s Exploration Medical Capability Element that successfully demonstrated the capability to produce in-situ IV fluids aboard the ISS in 2010 using an ISS potable water source. Flight demonstration objectives for this system included purification via packed bed resin, bubble removal, sterilization, passive mixing in microgravity, and United States Pharmacopeia (USP) tested compliance. The project will culminate in a flight technical demonstration on the ISS in 2025/2026.

Courtney M Schkurko↗
NASA NTRS2023

Identifying and Closing Medical Capability Gaps for Human Spaceflight Missions Beyond Low Earth Orbit

BACKGROUND: Features of human space missions beyond low Earth orbit such as increasing distance from Earth, lack of real-time communication, and limited or no evacuation or resupply capability are expected to drive an increase in medical risk and require crews to operate in an increasingly autonomous fashion. A diverse set of stakeholders at NASA are seeking to fund the development of concepts of operations, medical requirements, and medical capabilities for such missions. However, a systematic approach to identification of current medical capability gaps and a strategic framework to gap closure is needed. OVERVIEW: The Exploration Medical Integrated Product Team (XMIPT) has developed a list of nine high-level medical capability gaps and associated activities required for gap closure. The list was derived based on inputs from subject matter experts at NASA including flight surgeons, other clinical providers, as well as operational and research communities regarding medical capabilities required to support human missions to the Moon and the Mars surface. Responses were reviewed and distilled to identify common themes across capabilities. To ensure alignment with established human system risks, the gap list was further refined based on inputs from NASA’s Human System Risk Board. Relevant medical gap closure activities outside of those funded by the XMIPT were identified through solicitation of inputs from Elements of NASA’s Human Research Program (particularly Exploration Medical Capability), the broader medical operations community, and other stakeholders. This medical capability gap list is reviewed and updated regularly as new information becomes available or new stakeholders are identified. DISCUSSION: The medical capability gap list has matured to include a large group of NASA stakeholders and development activities. This has enabled articulation of priorities to funding entities and programmatic stakeholders, while serving as an accessible resource summarizing gap closure activities, relevant programmatic infusion points, and opportunities for collaboration between stakeholders. This presentation will provide an overview of the nine NASA medical capability gaps and their associated gap closure activities.

Moriah Thompson↗
NASA NTRS2023

Exploration Electronic Health Record (xEHR) Techport Entry

Exploration missions beyond low Earth orbit will experience significant communication delays and communication black outs that will necessitate asynchronous, increasingly Earth-independent provision of medical care to onboard crew. In this new paradigm, the Crew Medical Officer (CMO), other Crewmembers, and ground support will have to quickly, efficiently, and independently, view medical data, make decisions, and relay important information. Currently, the NASA electronic health record (EHR) is intended only for ground use and is not accessible to in-mission ISS crew for medical decision support and communication. An EHR capable of providing the crew health data, medical store-and-forward communications, and necessary medical administrative tools is critical in enabling NASA’s standard of healthcare during increasingly autonomous operations. The Exploration Medical Integrated Product Team (XMIPT) project called Medical Exploration Development and Implementation Scoping (MEDIScope) developed and reviewed objectives and concept of operations for an exploration EHR (xEHR) with project stakeholders, developed preliminary high-level requirements, and coordinated the handoff of the project to a design and implementation team at the Johnson Space Center (JSC). This JSC team will develop system requirements for the xEHR with inputs from subject matter experts. Following final requirements development, a team will be chosen to develop the xEHR and to conduct a demonstration on a future exploration vehicle such as Gateway.

MEDIScope↗
NASA NTRS2023

Automated Medical Inventory System (AMIS) TechPort Entry

The current medical inventory paradigm on the International Space Station (ISS) requires crew to report use of medications and supplies to be manually decremented by ground teams. This method is not only tedious and time consuming for both the crew and ground teams but also results in inaccuracies in location and availability of medical supplies over time. Fortunately, the ISS is frequently resupplied by cargo launches and crew expeditions, and an accurate inventory count is less critical. However, for exploration missions, resupply will be greatly limited or unavailable entirely, and increasing communication latency will impair crew-ground communications. On longer missions, with large medical systems and time constrained crew, NASA needs a method of accurately managing medical inventory without reliance on ground teams and with as little crew time and effort as possible. The Exploration Medical Integrated Product Team (XMIPT) project called Medical Exploration Development and Implementation Scoping (MEDIScope) prepared a concept of operations and preliminary requirements for an Automated Medical Inventory System (AMIS) and completed a market survey and trade study of potential inventory management technologies in partnership with the market research firm, yet2. The products from the MEDIScope effort, including the market survey results, preliminary functional requirements and a concept of operations, have been handed off to a development team at Glenn Research Center (GRC) and ZIN Technologies for technology maturation. In the development phase, the AMIS team will finalize system requirements, down select technologies, integrate with a future exploration Crew Health and Performance Integrated Data Architecture, and conduct design reviews. The project will culminate in an ISS technical flight demonstration in FY27.

MEDIScope↗
NASA NTRS2019

Supplying a Pharmacy for NASA Exploration Spaceflight: Challenges and Current Understanding

In order to maintain crew health and performance during long-duration spaceflight outside of low-Earth orbit, NASA and its international partners must be capable of providing a safe and effective pharmacy. Given few directed studies of pharmaceuticals in the space environment, it is difficult to characterize pharmaceutical effectiveness or stability during spaceflight; this in turn makes it challenging to select an appropriate formulary for exploration. Here we present the current state of literature regarding pharmaceutical stability, metabolism, and effectiveness during spaceflight. In particular, we have attempted to highlight the gaps in current knowledge and the difficulties in translating terrestrial-based drug studies to a meaningful interpretation of drug stability, safety, and effectiveness in space. We hope to identify high-yield opportunities for future research that might better define and mitigate pharmaceutical risk for exploration missions.

Rebecca S Blue↗
NASA NTRSDate not supplied

Developing A New Medical Condition List for Exploration Spaceflight

For the last decade, the National Aeronautics and Space Administration (NASA) has utilized a probabilistic risk analysis tool called the Integrated Medical Model (IMM), which contains 100 medical conditions, to conduct medical trade-space analyses and risk assessments for International Space Station (ISS) operations. Planning for future missions to the Moon and Mars will require updated tools and evidence that consider the unique features of exploration missions. To address this need, the Exploration Medical Capability (ExMC) Element of the NASA Human Research Program is developing an advanced trade-space analysis tool suite, IMPACT. As a part of this effort, ExMC has produced the IMPACT version 1 Condition List (ICL 1.0) which expands the scope and definition of medical conditions.

Amy Jean Kreykes↗
NASA NTRSDate not supplied

Venous Gas Embolism: Review to Quantify a Safe Volume of Air in Intravenous Fluids Bags for Spaceflight Applications

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.

Christopher R Woodard↗
NASA NTRSDate not supplied

Coordinated NASA Development of Medical Capabilities and Technologies for Deep Space Exploration

Building upon the success of the last two decades of human spaceflight medical operations onboard the International Space Station (ISS), NASA now must start to evolve to a deep space medical operations paradigm. This new paradigm will include myriad challenges including communication delays and blackouts, infrequent or unavailable resupply, potentially significant vehicle resource constraints, and delayed or non-existent evacuation options. To overcome these challenges, two separate but highly coordinated NASA groups are working together to develop and test solutions to these problems: the Exploration Medical Capability (ExMC) Element of the NASA Human Research Program and the Exploration Medical Integrated Product Team (XMIPT) of the Environmental Control and Life Support System – Crew Health and Performance Systems Capability Leadership Team. Although the work of these two groups is very complementary, ExMC generally focuses more on research and early technology development work while the XMIPT works on maturing and integrating new medical capabilities for exploration. During this panel, these two groups together will present details on how medical capability gaps are defined and addressed, a new work plan in development to increase medical autonomy in spaceflight, a technology maturation effort to generate intravenous fluids from potable water onboard a spacecraft, multiple new technology demonstrations of in-situ laboratory analysis capabilities, and new onboard tools to advance medical care for deep space missions.

Kris Lehnhardt↗
NASA NTRSDate not supplied

Preparation for an Earth Independent Medical Operations Demonstration using the Tempus ALS™ Medical Device

NASA’s exploration-class missions have severe resource constraints, long return trip durations, significant communication delays and limited resupply opportunities. Validation on the International Space Station (ISS) of medical devices that fit within Earth-Independent Medical Operations (EIMO) systems is a necessary preparation step. Key features of an EIMO medical system include: 1) technologies that support the prevention, diagnosis, and treatment of spaceflight medical events; 2) components that meet mass, volume, power and crew time/training constraints; 3) consideration of the medical skill level of the astronaut caregiver; 4) collection, storage and analysis of medical data within a central data architecture; and 5) incorporation of appropriate guidance and support tools that allow crew autonomy. The Human Research Program’s (HRP) Exploration Medical Capability (ExMC) Element and the Exploration Medical Integrated Product Team (XM-IPT) are planning an ISS technology demonstration to determine the feasibility of including a multifunctional medical device into an EIMO medical system. Demonstration Preparations: The Tempus ALS (Remote Diagnostic Technologies, Ltd., Philips Corp., Farnborough, UK) is a commercial-off-the-shelf medical device, with United States Food and Drug Administration clearance and is Conformité Européene marked in Europe. Several thousand units have been sold and are successfully operating in pre-hospital and in remote settings, such as by European Space Agency (ESA) flight surgeons and some of NASA’s commercial partners during post-flight medical operations. The Tempus ALS provides vital sign measurements such as blood pressure, electrocardiograms, heart rate, end tidal CO2, respiration rate, pulse oximetry and temperature. The device has ultrasound imaging and video laryngoscopy capabilities and has automatic or manual defibrillation modes for treating cardiac arrhythmias. It includes procedural guidance capabilities to assist in the collection of the vital sign measurements and it has various data transmission and report generation features. NASA’s HRP ExMC and XM-IPT are partnering with the ESA to demonstrate the Tempus ALS on ISS, with ESA manifesting the Tempus ALS and its accessories. ESA will compare performance of periodic health status exams and medical contingency drills performed nominally and with the Tempus ALS. NASA’s EIMO demonstration will include the use of Tempus ALS to diagnose a complaint of abdominal pain under increasingly independent circumstances. The caregiver must assess the present illness, collect vital sign measurements, and perform an abdominal ultrasound, under one of three communication situations, including real-time, with a several second delay and with a delay on the order of minutes. Expected Outcomes: Information will be gained about the feasibility, benefits, and challenges of using a multifunctional, all-in-one, medical device for medical diagnosis instead of separate devices with singular functionalities. Information will also be collected about performance differences as communication delays increase and available ground support decreases. Gaining this understanding will allow for further development of exploration medical system capabilities which takes the EIMO construct into consideration.

Beth Lewandowski↗