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Stegmann, Barbara J.

Publications and source records attributed to Stegmann, Barbara J..

Evaluation of medical treatments to increase survival of ebullism in guinea pigs

Spaceflight carriers run a constant risk of exposure to vacuum. Above 63,000 ft (47 mmHg), the ambient pressure falls below the vapor pressure of water at 37 C, and tissue vaporization (ebullism) begins. Little is know about appropriate resuscitative protocols after such an ebullism exposure. This study identified injury patterns and mortality rates associated with ebullism while verifying effectiveness of traditional pulmonary resuscitative techniques. Male Hartley guinea pigs were exposed to 87,000 ft for periods of 40 to 115 sec. After descent, those animals that did not breathe spontaneously were given artificial ventilation by bag and mask for up to 15 minutes. Those animals surviving were randomly assigned to one of three treatment groups--hyperbaric oxygen (HBO), ground-level oxygen (GLO2), and ground-level air (GLAIR). The HBO group was treated on a standard treatment table 6A while the GLO2 animals received O2 for an equivalent length of time. Those animals in the GLAIR group were observed only. All surviving animals were humanely sacrified at 48 hours. Inflation of the animal's lungs after the exposure was found to be difficult and, at times, impossible. This may be due to surfactant disruption at the alveolar lining. Electron microscopy identified a disruption of the surfactant layer in animals that did not survive initial exposure. Mortality was found to increase with exposure time: 40 sec--0 percent; 60 sec--6 percent; 70 sec--40 percent; 80 sec--13 percent; 100 sec--38 percent; 110 sec--40 percent; and 115 sec--100 percent. There was no difference in the delayed mortality among the treatment groups (HBO--15 percent, GLO2--11 percent, GLAIR--11 percent). However, since resuscitation was ineffective, the effectiveness of any post-exposure treatment was severely limited. Preliminary results indicate that reuscitation of guinea pigs following ebullism exposure is difficult, and that current techniques (such as traditional CPR) may not be appropriate.

Stegmann, Barbara J.↗

The 1990 Hypobaric Decompression Sickness Workshop: Summary and conclusions

Decompression sickness resulting from exposure to the hypobaric environment was reviewed and discussed at a three day workshop in Oct. 1990. This milestone meeting, attended by over 50 participants representing the Dept. of Defense, NASA, ESA, and academia, updated the current understanding of altitude decompression sickness (DCS). Both research and operational aspects of this illness were addressed through presentations on the pathophysiology and clinical manifestations of DCS, its incidence in aviation and space operations, and existing and proposed measures for DCS prevention. Specific areas requiring further research were also identified. A summary is presented for the material given at the workshop.

Pilmanis, Andrew A.↗

Improving survival after tissue vaporization (Ebullism)

Exposure of unprotected humans to altitudes above 63,000 ft results in ebullism. Ebullism occurs when the vapor pressure of tissues is less than the ambient pressure and the tissues spontaneously 'boil'. This may result in rapid unconsciousness, cardiac vaporlock, pulmonary collapse, cerebral anoxia, and sometimes even death. Potential places for this include EVA accidents in space, aircraft experiencing rapid decompression at high altitudes with cabin or pressure suit failure, and accidents during pressure suit training exercises. The pathophysiology of ebullism was studied in the 40's to 60's using animal models. There is one report of a prolonged, unprotected human exposure and several anecdotal of unprotected short term exposures to near vacuum. In addition to pulmonary and neurologic concerns, unprotected exposure of the head may result in freezing of the corneal surface of the eye. Surface eye freezing may impair vision and significantly impact mission completion. At this time, little data are available on the effectiveness of conventional treatment protocols, such as hyperbaric oxygen, for ebullism induced injuries. Research is needed to assess the efficacy of other adjunctive therapies such as high frequency ventilation and cerebral protective drugs that are still under development.

Stegmann, Barbara J.↗