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NASA NTRS1996

Cardiovascular Deconditioning and Venous Air Embolism in Simulated Microgravity in the Rat

Astronauts conducting extravehicular activities undergo decompression to a lower ambient pressure, potentially resulting in gas bubble formation within the tissues and venous circulation. Additionally, exposure to microgravity produces fluid shifts within the body leading to cardiovascular deconditioning. A lower incidence of decompression illness in actual spaceflight compared with that in ground-based altitude chamber flights suggests that there is a possible interaction between microgravity exposure and decompression illness. The purpose of this study was to evaluate the cardiovascular and pulmonary effects of simulated hypobaric decompression stress using a tail suspension (head-down tilt) model of microgravity to produce the fluid shifts associated with weightlessness in conscious, chronically instrumented rats. Venous bubble formation resulting from altitude decompression illness was simulated by a 3-h intravenous air infusion. Cardiovascular deconditioning was simulated by 96 h of head-down tilt. Heart rate, mean arterial blood pressure, central venous pressure, left ventricular wall thickening and cardiac output were continuously recorded. Lung studies were performed to evaluate edema formation and compliance measurement. Blood and pleural fluid were examined for changes in white cell counts and protein concentration. Our data demonstrated that in tail-suspended rats subjected to venous air infusions, there was a reduction in pulmonary edema formation and less of a decrease in cardiac output than occurred following venous air infusion alone. Mean arterial blood pressure and myocardial wall thickening fractions were unchanged with either tail-suspension or venous air infusion. Heart rate decreased in both conditions while systemic vascular resistance increased. These differences may be due in part to a change or redistribution of pulmonary blood flow or to a diminished cellular response to the microvascular insult of the venous air embolization.

Robinson, R. R.↗

NASA NTRS1993

Breathing 100% oxygen compared with 50% oxygen: 50% nitrogen reduces altitude-induced venous gas emboli

The risk of venous gas emboli (VGE) and decompression sickness (DCS) must be determined before selection of the lowest pressure for an extravehicular activity (EVA) pressure suit which eliminates the requirement for prebreathing. In earlier studies, use of a 50% oxygen:50% nitrogen breathing mixture (50:50 mix) during 139 zero-prebreathe decompressions of male subjects to 8.3-7.8 psia resulted in 51 instances of severe VGE and one case of DCS. Our current study investigated effects of 40 zero-prebreathe decompressions of male subjects to 8.3-6.8 psia for 6 h while breathing 100% oxygen and performing moderate exercise. No DCS symptoms were observed. Severe VGE were not detected at 8.3 psia, but were present during 10%, 20%, and 40% of the exposures at 7.8, 7.3, and 6.8 psia, respectively. Zero-prebreathe decompression while breathing 100% oxygen results in significantly lower VGE and DCS risk levels than while breathing a 50:50 mix. Our results show that 7.3 psia EVA pressure suits with 100% oxygen should be safer than 8.3 psia suits with a 50:50 mix.

NASA Program Environmental Health↗

NASA NTRS1990

Hyperbaric treatment

Viewgraphs on hyperbaric treatment are presented. Topics covered include: hyperbaric treatment - purpose; decompression sickness; sources of decompression sickness; physical description; forms of decompression sickness; hyperbaric treatment of decompression sickness; and duration of treatment.

Amoroso, Michael T.↗

NASA NTRS1993

Project ARGO: Gas phase formation in simulated microgravity

The ARGO study investigated the reduced incidence of joint pain decompression sickness (DCS) encountered in microgravity as compared with an expected incidence of joint pain DCS experienced by test subjects in Earth-based laboratories (unit gravity) with similar protocols. Individuals who are decompressed from saturated conditions usually acquire joint pain DCS in the lower extremities. Our hypothesis is that the incidence of joint pain DCS can be limited by a significant reduction in the tissue gas micronuclei formed by stress-assisted nucleation. Reductions in dynamic and kinetic stresses in vivo are linked to hypokinetic and adynamic conditions of individuals in zero g. We employed the Doppler ultrasound bubble detection technique in simulated microgravity studies to determine quantitatively the degree of gas phase formation in the upper and lower extremities of test subjects during decompression. We found no evidence of right-to-left shunting through pulmonary vasculature. The volume of gas bubble following decompression was examined and compared with the number following saline contrast injection. From this, we predict a reduced incidence of DCS on orbit, although the incidence of predicted mild DCS still remains larger than that encountered on orbit.

Powell, Michael R.↗

NASA NTRS1997

Studies Relating to EVA

In this session, Session JA1, the discussion focuses on the following topics: The Staged Decompression to the Hypobaric Atmosphere as a Prophylactic Measure Against Decompression Sickness During Repetitive EVA; A New Preoxygenation Procedure for Extravehicular Activity (EVA); Metabolic Assessments During Extra-Vehicular Activity; Evaluation of Safety of Hypobaric Decompressions and EVA From Positions of Probabilistic Theory; Fatty Acid Composition of Plasma Lipids and Erythrocyte Membranes During Simulation of Extravehicular Activity; Biomedical Studies Relating to Decompression Stress with Simulated EVA, Overview; The Joint Angle and Muscle Signature (JAMS) System - Current Uses and Future Applications; and Experimental Investigation of Cooperative Human-Robotic Roles in an EVA Work Site.

Source record↗

NASA NTRS2002

The effect of exercise and rest duration on the generation of venous gas bubbles at altitude

BACKGROUND: Decompression, as occurs with aviators and astronauts undergoing high altitude operations or with deep-sea divers returning to surface, can cause gas bubbles to form within the organism. Pressure changes to evoke bubble formation in vivo during depressurization are several orders of magnitude less than those required for gas phase formation in vitro in quiescent liquids. Preformed micronuclei acting as "seeds" have been proposed, dating back to the 1940's. These tissue gas micronuclei have been attributed to a minute gas phase located in hydrophobic cavities, surfactant-stabilized microbubbles, or arising from musculoskeletal activity. The lifetimes of these micronuclei have been presumed to be from a few minutes to several weeks. HYPOTHESIS: The greatest incidence of venous gas emboli (VGE) will be detected by precordial Doppler ultrasound with depressurization immediately following lower extremity exercise, with progressively reduced levels of VGE observed as the interval from exercise to depressurization lengthens. METHODS: In a blinded cross-over design, 20 individuals (15 men, 5 women) at sea level exercised by performing knee-bend squats (150 knee flexes over 10 min, 235-kcal x h(-1)) either at the beginning, middle, or end of a 2-h chair-rest period without an oxygen prebreathe. Seated subjects were then depressurized to 6.2 psia (6,706 m or 22,000 ft altitude equivalent) for 120 min with no exercise performed at altitude. RESULTS: Of the 20 subjects with VGE in the pulmonary artery, 10 demonstrated a greater incidence of bubbles with exercise performed just prior to depressurization, compared with decreasing bubble grades and incidence as the interval of rest increased prior to depressurization. No decompression illness was reported. CONCLUSIONS: There is a significant increase in decompression-induced bubble formation at 6.2 psia when lower extremity exercise is performed just prior to depressurization as compared with longer rest intervals. Analysis indicated that micronuclei half-life is on the order of an hour under these hypobaric conditions.

Controlled Clinical Trial↗

NASA NTRS1998

A new preoxygenation procedure for extravehicular activity (EVA)

A 10.2 psi staged-decompression schedule or a 4-hour preoxygenation at 14.7 psi is required prior to extravehicular activity (EVA) to reduce decompression sickness (DCS) risk. Results of recent research at the Air Force Research Laboratory (AFRL) showed that a 1-hour resting preoxygenation followed by a 4-hour, 4.3 psi exposure resulted in 77% DCS risk (N=26), while the same profile beginning with 10 min of exercise at 75% of VO2peak during preoxygenation reduced the DCS risk to 42% (P<.03; N=26). A 4-hour preoxygenation without exercise followed by the 4.3 psi exposure resulted in 47% DCS risk (N=30). The 1-hour preoxygenation with exercise and the 4-hour preoxygenation without exercise results were not significantly different. Elimination of either 3 hours of preoxygenation or 12 hours of staged-decompression are compelling reasons to consider incorporation of exercise-enhanced preoxygenation.

NASA Discipline Environmental Health↗

NASA NTRS1972

Pulmonary Edema and Plasma Volume Changes in Dysbarism

Two groups of anesthetized, fasted pigs were utilized. One group of 13 animals (8.5 to 16.6 kilograms) was exposed to a high-pressure environment, and the other group of eight animals (6.9 to 20.0 kilograms) constituted the control group. The experimental group was subjected to an atmosphere of 90 percent nitrogen and 10 percent oxygen at a pressure of 50 psig for 30 minutes and then decompressed at a rate 10 psi/min. Plasma volumes, using both iodine-125-tagged-albumin and chromium-51-tagged-cell dilution techniques, were measured before, immediately after, and at 30 and 60 minutes after decompression. Aortic and right-ventricular systolic pressures were also recorded. At 60 minutes after decompression, blood samples were taken, the animals were sacrificed, and the water content of the lungs, kidneys, livers, and spleens was estimated by measuring tissue wet weight and dry weight. Protein extravasation and tissue blood volumes were determined by measuring the iodine-125-tagged-albumin and chromium-51-tagged-cell spaces in homo-genates of the organs under investigation.

Joki, J. A.↗

NASA NTRS1985

Increase of plasma renin activity in male and female rabbits subjected to dysbaric conditions

The renin-angiotensin-aldosterone system may be implicated in hemodynamic alterations occurring in dysbaric disorders. This report concerns changes in plasma renin activity (PRA) induced by exposure of rabbits to a compression-decompression schedule that does not normally produce clinical manifestations of decompression sickness. The results revealed a significant increase in PRA in 19 of 23 animals following dysbaric exposure. Mean PRA rose from 1.18 ng ang I/ml hr (preexposure) to 2.40 ng ang I/ml hr (postexposure). The increase was particularly pronounced in female animals (217 percent). Asymptomatic intravascular gas bubbles (silent bubbles) were detected by gross or microscopic examination in the majority of the animals. Renin elaboration and secretion in asymptomatic dysbaric exposures may be mediated by bradykinin and/or prostaglandins released or activated in a chain reaction triggered by silent gas bubbles. This hypothesis is also applicable to increased PRA in altitude decompression. Alternatively elevation of PRA may result from decreased renal perfusion when dysbaric disorders are complicated by significant hypovolemia.

Chryssanthou, C.↗

NASA NTRS1990

Silent bubbles - Their effects and detection

This paper discusses the concept of the 'silent bubble' (a phenomenon due to gas phase formation in tissues, which does not lead to frank decompression sickness). Special attention is given to the conditions for silent bubbles formation, the methods of their detecton, and to their pathophysiology. Data relating the gas formation in blood and the symptoms of decompression sickness indicate that the distinction between the silent bubbles and clinical ones is often vague and that a bubble-free decompression never existed.

Powell, Michael R.↗

NASA NTRS1992

Saline ingestion during lower body negative pressure as an end-of-mission countermeasure to post-space flight orthostatic intolerance

Lower body negative pressure (LBNP) in conjunction with saline ingestion can protect astronauts against post-space flight orthostatic intolerance. LBNP was used for both treatment and testing. The treatment was 4 hours of lower body decompression at 30 mm Hg below ambient pressure. One liter of water and 8 g of salt were ingested during the first hour. The treatment was evaluated by comparing heart rate (HR) and blood pressure (BP) responses to test decompressions on the days before and after treatment. It is concluded that cardiovascular responses to step-wise decompression duplicated Skylab findings. BP was maintained, but HR responses to each step were progressively greater in-flight than preflight. After the 4-hour treatment HR responses were closer to preflight values.

Charles, John B.↗

NASA NTRS1993

Breathing 100 percent oxygen compared with 50 percent oxygen:50 percent nitrogen reduces altitude-induced venous gas emboli

The study investigates effects of 40 zero-prebreathe decompressions of male subjects to 8.3-6.8 psia for 6 h while they were breathing 100 percent oxygen and performing moderate exercise. No decompression sickness (DCS) symptoms were observed. Severe venous gas emboli (VGE) were not detected at 8.3 psia, but were present during 10, 20, and 40 percent of the exposures at 7.8, 7.3, and 6.8 psia, respectively. Zero-prebreathe decompression while breathing 100 percent oxygen results in significantly lower VGE and DCS risk levels than while breathing a 50:50 mix. It is shown that 7.3 psia EVA pressure suits with 100 percent oxygen should be safer than 8.3 psia suits with a 50:50 mix.

Webb, James T.↗

NASA NTRS1996

Study of Hind Limb Tissue Gas Phase Formation in Response to Suspended Adynamia and Hypokinesia

The purpose of this study was to investigate the hypothesis that reduced joint/muscle activity (hypo kinesia) as well as reduced or null loading of limbs (adynamia) in gravity would result in reduced decompression-induced gas phase and symptoms of decompression sickness (DCS). Finding a correlation between the two phenomena would correspond to the proposed reduction in tissue gas phase formation in astronauts undergoing decompression during extravehicular activity (EVA) in microgravity. The observation may further explain the reported low incidence of DCS in space.

Butler, Bruce D.↗

NASA NTRS1999

Barophysiology and Biophysics

Decompression is an important aspect of extravehicular activity (EVA). Errors can result in decompression sickness (DCS) if the protective measures are too liberal, while valuable on-orbit time is dissipated in prophylactic methodologies that are excessively conservative. Nucleation is an important consideration in many natural events, and its control is very important in many industrial procedures. The amount of Extravehicular Activity (EVA) that will be required during the construction of the International Space Station exceeds all of the other activity combined. The requirements in astronaut time and consumables (breathing oxygen and air) will be considerable. In an attempt to mitigate these requirements, Project ARGO was investigated in 1990 to investigate the effects of gravitational forces on the musculoskeletal system. This work has led to the present plans for the reduction of prebreathe duration. Over the past decade, research has been directed towards an understanding of the biophysical basis of the formation and growth of the decompression gas phase with the goal of improving the efficiency of the EVA process. In the past, we have direct work towards a more complete understanding of gas bubble formation and growth and exercise-enhanced washout during oxygen prebreathe.

Powell, Michael R.↗

NASA NTRS2000

A Mathematical Model of Diffusion-Limited Gas Bubble Dynamics in Tissue with Varying Diffusion Region Thickness

A three-region mathematical model of gas bubble dynamics has been shown suitable for describing diffusion-limited dynamics of more than one bubble in a given volume of extravascular tissue. The model is based on the dynamics of gas exchange between a bubble and a well-stirred tissue region through an intervening unperfused diffusion region previously assumed to have constant thickness and uniform gas diffusivity. As a result, the gas content of the diffusion region remains constant as the volume of the region increases with bubble growth, causing dissolved gas in the region to violate Henry's law. Earlier work also neglected the relationship between the varying diffusion region volume and the fixed total tissue volume, because only cases in which the diffusion region volume is a small fraction of the overall tissue volume were considered. We herein extend the three-region model to correct these theoretical inconsistencies by allowing both the thickness and gas content of the diffusion region to vary during bubble evolution. A postulated difference in gas diffusivity between an infinitesimally thin layer at the bubble surface and the remainder of the diffusion region leads to variation in diffusion region gas content and thickness during bubble growth and resolution. This variable thickness, differential diffusivity (VTDD) model can yield bubble lifetimes considerably longer than those yielded by earlier three-region models for given model and decompression parameters, and meets a need for theoretically consistent but relatively simple bubble dynamics models for use in studies of decompression sickness (DCS) in human subjects, Keywords: decompression sickness, gas diffusion in tissue, diffusivity

Srinivasan, R. Srini↗

NASA NTRS2007

Comparison of V-4 and V-5 Exercise/Oxygen Prebreathe Protocols to Support Extravehicular Activity in Microgravity

The Prebreathe Reduction Program (PRP) used exercise during oxygen prebreathe to reduce necessary prebreathe time prior to depressurizing to work in a 4.3 psi suit during extravehicular activity (EVA). Initial testing produced a two-hour protocol incorporating ergometry exercise and a 30 min cycle of depress/repress to 10.2 psi where subjects breathed 26.5% oxygen/balance nitrogen (Phase II - 10 min at 75% peak oxygen consumption [VO2 peak] followed by 40 min intermittent light exercise [ILE] [approx. 5.8 mL-per kilogram- per minute], then 50 min of rest). The Phase II protocol (0/45 DCS) was approved for operations and has been used on 40 EVAs, providing significant time savings compared to the standard 4 h resting oxygen prebreathe. The Phase V effort focused on performing all light in-suit exercise. Two oxygen prebreathe protocols were tested sequentially: V-4) 160 min prebreathe with 150 min of continuous ILE. The entire protocol was completed at 14.7 psi. All exercise involved upper body effort. Exercise continued until decompression. V-5) 160 min prebreathe with 140 min of ILE - first 40 min at 14.7 psi, then 30 min at 10.2 psi (breathing 26.5% oxygen) after a 20 min depress, simulating a suit donning period. Subjects were then repressed to 14.7 psi and performed another 50 min of lower body ILE, followed by 50 min rest before decompression. The V-4 protocol was rejected with 3 DCS/6 person-exposures. Initial V-5 testing has produced 0 DCS/11 person-exposures (ongoing trials). The difference in DCS rate was significant (Fisher Exact p=0.029). The observations of DCS were significantly lower in early V-5 trials than in V-4 trials. Additional studies are required to evaluate the relative contribution of the variables in exercise distribution, the 10.2 psi depress/repress component, pre-decompression rest, or possible variation in total oxygen consumption.

Pollock, N. W.↗

NASA NTRS2009

Use of Intermittent Recompression and Nitrox Breathing Mixtures during Lunar Extravehicular Activities

INTRODUCTION: NASA's plans for lunar surface exploration include pressurized suitport rovers that are quickly ingressed and egressed with minimal consumables losses. This capability enables crewmembers to perform multiple short extravehicular activities (EVAs) at different locations in a single day versus a single 8-hr EVA. Modeling work and empirical human and animal data indicate that intermittent recompressions between EVA suit pressure and cabin pressure reduce decompression stress. Savings in crew time and gas losses may also be achieved if the N2 purge is shortened to 2 minutes, achieving 80% O2 (vs. 8 minutes, 95% O2). METHODS: A validated Tissue Bubble Dynamics Model was used to predict decompression stress using 80% and 95% O2 breathing mixtures during 3 x 2-hr EVAs (4.3 PSIA) with 1hr recompressions back to 8.0 PSIA (32% O2) versus a single 8-hr EVA. 15 minutes was spent at 6.0 PSIA before depressurizations to 4.3 PSIA; initial EVA tasks could be performed during this time. Model validation was based on significant prediction (p<0.001) and goodness of fit with 84 cases of DCS in 668 altitude exposures (McFadden s rho-squared=0.214). RESULTS: A 2.2% predicted increase in DCS risk due to the shortened purge is more than compensated for by a predicted 2.5% reduction in DCS risk due to intermittent recompression. 15 minutes at 80% O2, 6.0 PSIA prior to a 4.3 PSIA EVA prevents supersaturation in the brain and spinal cord (5-10 minute half-time compartments) and reduces tissue tensions in 40 min compartments, where most of the body s inert gas is located, to approximately the same levels (4.39 vs 4.00 PSIA) as achieved during a 40 min 95% O2 prebreathe at 10.2 PSIA. CONCLUSIONS: Intermittent recompressions between lunar EVAs may enable reductions in suit purge and prebreathe requirements, decompression stress, and/or suit operating pressures.

Gernhardt, M.L.↗

NASA NTRS2010

Defining Nitrogen Kinetics for Air Break in Prebreath

Actual tissue nitrogen (N2) kinetics are complex; the uptake and elimination is often approximated with a single half-time compartment in statistical descriptions of denitrogenation [prebreathe(PB)] protocols. Air breaks during PB complicate N2 kinetics. A comparison of symmetrical versus asymmetrical N2 kinetics was performed using the time to onset of hypobaric decompression sickness (DCS) as a surrogate for actual venous N2 tension. METHODS: Published results of 12 tests involving 179 hypobaric exposures in altitude chambers after PB, with and without airbreaks, provide the complex protocols from which to model N2 kinetics. DCS survival time for combined control and airbreaks were described with an accelerated log logistic model where N2 uptake and elimination before, during, and after the airbreak was computed with a simple exponential function or a function that changed half-time depending on ambient N2 partial pressure. P1N2-P2 = (Delta)P defined decompression dose for each altitude exposure, where P2 was the test altitude and P1N2 was computed N2 pressure at the beginning of the altitude exposure. RESULTS: The log likelihood (LL) without decompression dose (null model) was -155.6, and improved (best-fit) to -97.2 when dose was defined with a 240 min half-time for both N2 elimination and uptake during the PB. The description of DCS survival time was less precise with asymmetrical N2 kinetics, for example, LL was -98.9 with 240 min half-time elimination and 120 min half-time uptake. CONCLUSION: The statistical regression described survival time mechanistically linked to symmetrical N2 kinetics during PBs that also included airbreaks. The results are data-specific, and additional data may change the conclusion. The regression is useful to compute additional PB time to compensate for an airbreak in PB within the narrow range of tested conditions.

Conkin, Johnny↗