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The medical aspects of space flight are briefly discussed. The problems of space adaptation syndrome, commonly known as space sickness, are described, and its cause is shown. The adaptation of the cardiovascular system to weightlessness, the problems of radiation in space, atrophy of bones and muscles, and loss of blood volume are addressed. The difficulties associated with the reexperience of gravity on return to earth are briefly considered.
The physiological adaptation to weightless exposure includes cardiovascular deconditioning arising in part from a loss of total circulating blood volume and resulting in a reduction of orthostatic tolerance. The crew of the Shuttle orbiter are less tolerant to acceleration forces in the head-to-foot direction during the reentry phase of the flight at a time they must function at a high level of performance. The factors that contribute to orthostatic intolerance during and following reentry and to predict the likelihood of impaired crew performance are evaluated. A computer simulation approach employing a mathematical model of the cardiovascular system is employed. It is shown that depending on the severity of blood volume loss, the reentry acceleration stress may be detrimental to physiologic function and may place the physiologic status of the crew near the borderline of some type of impairment. They are in agreement with conclusions from early ground-based experiments and from observations of early Shuttle flights.
The effects of lower body negative pressure (LBNP) on the cardiovascular response of 20 women between 23-43 years are evaluated. Calf circumference and cardiovascular data were recorded for women in the follicular and luteal phases of the menstrual cycle at -30, -40, and -50 mm Hg LBNP. The data reveal that the two menstrual phases did not cause differences in the way women respond to LBNP. It is observed that during LBNP calf circumference is enlarged; transthoracic impedance, and heart rate are increased; stroke volume, left ventricular ejection time, the Heather Index of contractility and systolic pressure, and cardiac output are reduced; and total peripheral resistance is elevated. The experimental data are compared to Montgomery et al. (1979). It is noted that the response of women to -50 mm Hg LBNP is similar to that of men; however, women adapt to stresses on the cardiovascular system with greater heart rate adjustments.
The results of the Cosmos 1514 cardiovascular experiment, in which the blood flow to the head and the carotid pressure of a rhesus monkey were measured during the 5-d spaceflight, are reported. A single cylindrical probe containing both pressure and flow transducers was chronically implanted as a cuff around the left common carotid artery; measurements were obtained for 4 min every 2 h and compared to identical recordings obtained during a preflight control period and during 12 h on a launch pad. Immediately on its insertion into orbit, mean arterial pressure increased by 10 percent and has maintained a 16-27 percent increase over the first few hours of flight before returning to baseline level. Blood flow showed reciprocal changes to pressure on orbital insertion. Cardiovascular system changes persisted into the second day of flight, with the signs of adaptation appearing on days 3-5.
Bed rest has been a normal procedure used by physicians for centuries in the treatment of injury and disease. Exposure of patients to prolonged bed rest in the horizontal position induces adaptive deconditioning responses. While deconditioning responses are appropriate for patients or test subjects in the horizontal position, they usually result in adverse physiological responses (fainting, muscular weakness) when the patient assume the upright posture. These deconditioning responses result from reduction in hydrostatic pressure within the cardiovascular system, virtual elimination of longitudinal pressure on the long bones, some decrease in total body metabolism, changes in diet, and perhaps psychological impact from the different environment. Almost every system in the body is affected. An early stimulus is the cephalic shift of fluid from the legs which increases atrial pressure and induces compensatory responses for fluid and electrolyte redistribution. Without countermeasures, deterioration in strength and muscle function occurs within 1 wk while increased calcium loss may continue for months. Research should also focus on drug and carbohydrate metabolism.
The details of studies to be carried out jointly by French and American teams on two rhesus monkeys prepared for future experiments aboard the Space Shuttle are discussed together with the equipment involved. Seven science discipline teams were formed, which will study the effects of flight and/or weightlessness on the bone and calcium metabolism, the behavior, the cardiovascular system, the fluid balance and electrolytes, the muscle system, the neurovestibular interactions, and the sleep/biorhythm cycles. New behavioral training techniques were developed, in which the animals were trained to respond to behavioral tasks in order to measure the parameters involving eye/hand coordination, the response time to target tracking, visual discrimination, and muscle forces used by the animals. A large data set will be obtained from different animals on the two to three Space Shuttle flights; the hardware technologies developed for these experiments will be applied for primate experiments on the Space Station.
The experiments planned for the Spacelab Life Sciences-1 (SLS-1) Shuttle mission, which is dedicated to investigating biomedical issues pertinent to the man's presence in space, are discussed. The areas of research will include human and animal experiments concerned with the cardiovascular system, the vestibular apparatus, and metabolic experiments related to renal endocrine function, hematology, immune system, and muscle and bone/calcium metabolism, with particular attention given to the physiological complications resulting from short-duration space flight and subsequent return to the 1-G environment. The hardware systems to be used on the SLS-1 mission represent prototypes of systems to be developed for the medical and research facilities of the Space Station. The results of the experiments will be used to address issues related to long-duration space flight required for the Space Station and interplanetary travels.
The medical factors affecting the duration of manned space missions are reviewed. Topics addressed include the effects of weightlessness on body fluids, the cardiovascular system, red blood cells, the musculoskeletal system, the immune system, and the nervous system and the problems encountered in readaptation to normal gravity for each of these systems. Also discussed are the effects of radiation exposure, altered circadian rhythms, and closed environments. Plans for in-flight health care on the International Space Station are briefly outlined.
Data from Skylab and Space Shuttle missions are used as a framework for discussing the physiological effects of space flight. Consideration is given to motion sickness, and changes in body fluids, the cardiovascular system, and red blood cell counts. In addition, changes in muscle mass, bone mass, and the immune system, and neurosensory disturbances are examined.
Terrestrial animals have adapted to a constant gravitational stress over millions of years. Tissues of the cardiovascular system and lumbar spine in tall species of animals such as the giraffe are particularly well adapted to high and variable vectors of gravitational force. Swelling of the leg tissues in the giraffe is prevented by a variety of physiological mechanisms including (1) a natural 'antigravity suit', (2) impermeable capillaries, (3) arterial-wall hypertrophy, (4) variable blood pressures during normal activity, and (5) a large-capacity lymphatic system. These adaptations, as well as a natural hypertension, maintain blood perfusion to the giraffe's brain. The intervertebral disk is another tissue that is uniquely adapted to gravitational stress. Tall and large terrestrial animals have higher swelling pressures than their smaller or aquatic counterparts. Finally, the meniscus of the rabbit knee provides information on the effects of aging and load-bearing on cartilaginous tissues. Such tissues within the joints of animals are important for load-bearing on Earth; these connective tissues may degenerate during long-duration space flight.
The effects of gravity on the cardiovascular system must be taken into account whenever a hemodynamic assessment is made. All intravascular pressure have a gravity-dependent hydrostatic component. The interaction between the gravitational field, the position of the body, and the functional characteristics of the blood vessels determines the distribution of intravascular volume. In turn this distribution largely determines cardiac pump function. Multiple control mechanisms are activated to preserve optimal tissue perfusion when the magnitude of the gravitational field or its direction relative to the body changes. Humans are particularly sensitive to such changes because of the combination of their normally erect posture and the large body mass and blood volume below the level of the heart. Current aerospace technology also exposes human subjects to extreme variations in the gravitational forces that range from zero during space travel to as much an nine-times normal during operation of high-performance military aircraft. This chapter therefore emphasizes human physiology.
The present conference on findings from space life science investigations relevant to long-term earth orbit and planetary exploration missions, as well as considerations for future research projects on these issues, discusses the cardiovascular system and countermeasures against its deterioration in the microgravity environment, cerebral and sensorimotor functions, findings to date in endocrinology and immunology, the musculoskeletal system, and health maintenance and medical care. Also discussed are radiation hazards and protective systems, life-support and habitability factors, and such methodologies and equipment for long space mission research as the use of animal models, novel noninvasive techniques for space crew health monitoring, and an integrated international aerospace medical information system.
The purpose of NASA's Extended Duration Orbiter program is a gradual extension of the capabilities of the Space Shuttle Orbiter beyond its current 7-10 day limit on mission duration, as warranted by deepening understanding of the long-term physiological effects of weightlessness. Attention is being given to the cardiovascular problem of orthostatic tolerance loss due to its adverse effects on crew performance and health during reentry and initial readaptation to earth gravity. An account is given of the results of the application of proven mathematical models of circulatory and cardiovascular systems under microgravity conditions.
Results are presented from an experiment to determine whether lower body negative pressure (LBNP) produces a footward force equal to the product of the pressure differential and body cross-sectional area at the waist seal. Twelve male volunteers were sealed at the superior iliac crest in upright and supine LBNP chambers. Each subject was exposed to 10 mm Hg increments of LBNP up to 70 mm HG (standing) or to 50-100 mm Hg (supine), depending upon individual tolerance. Static reaction force was measured at each LBNP level for about 1-2 min. The forces measured during LBNP agreed well with forces calculated from the cross-sectional areas of the subjects' waists. It is inferred from these results that exercise in microgravity against 100 mm Hg LBNP could produce static and inertial forces similar in magnitude to those occurring on earth. It is concluded that this gravity-independent technique can help maintain the musculoskeletal and cardiovascular systems of crew members during prolonged exposure to microgravity.
NASA technical memorandum presents study of effects of weightlessness and simulations upon cardiovascular systems of humans and animals. Reviews research up to year 1987 in United States and Soviet space programs on such topics as physiological changes induced by weightlessness in outer space and by subsequent return to Earth gravity and also reviews deconditioning effects of prolonged bed rest on ground.
Maintenance of optimal health in humans requires the proper balance between exercise, rest, and sleep as well as time in the upright position. About one-third of a lifetime is spent sleeping; and it is no coincidence that sleeping is performed in the horizontal position, the position in which gravitational influence on the body is minimal. Although enforced bed rest is necessary for the treatment of some ailments, in some cases it has probably been used unwisely. In addition to the lower hydrostatic pressure with the normally dependent regions of the cardiovascular system, body fuid compartments during bed rest in the horizontal body position, and virtual elimination of compression on the long bones of the skeletal system during bed rest (hypogravia), there is often reduction in energy metabolism due to the relative confinement (hypodynamia) and alteration of ambulatory circadian variations in metabolism, body temperature, and many hormonal systems. If patients are also moved to unfamiliar surroundings, they probably experience some feelings of anxiety and some sociopsychological problems. Adaptive physiological responses during bed rest are normal for that environment. They are attempts by the body to reduce unnecessary energy expenditure, to optimize its function, and to enhance its survival potential. Many of the deconditioning responses begin within the first day or two of bed rest; these early responses have prompted physicians to insist upon early resumption of the upright posture and ambulation of bedridden patients.
Investigators have shown that after 1-2 weeks of bed rest ingestion of 1000 ml of a salt water solution during 4 hours of continuous exposure to 30 mm Hg of lower body negative pressure will protect plasma volume and orthostatic function for up to 24 hours. We hypothesize that a similar countermeasure will reduce the effects of fluid loss induced by headward fluid shift during space flight. The objective of this flight experiment is to evaluate the efficacy of the proposed countermeasure in reversing these effects on the cardiovascular system. Lower Body Negative Pressure (LBNP) involves exposing the legs and lower abdomen to reduced air pressure. The LBNP device is an air-tight chamber that seals the subject's waist to enclose the lower body. As used in this experiment, LBNP provides both the candidate treatment as well as the means of assessing the effectiveness of the treatment.
The recognition and understanding of cardiovascular adaptation to spaceflight has experienced substantial advancement in the last several years. In-flight echocardiographic measurements of astronaut cardiac function on the Space Shuttle have documented a 15 percent reduction in both left ventricular volume index and stroke volume with a compensatory increase in heart rate to maintain cardiac output. To date, the reduced cardiac size and stroke volume have been presumed to be the consequence of the reduction in circulating fluid volume following diuresis and other physiological processes to reduce blood volume within a few days after orbital insertion. However, no specific mechanism for the reduced stroke volume has been elucidated. The following investigation proposes the use of a hydraulic model of the cardiovascular system to examine the possibility that the observed reduction in stroke volume may, in part, be related to fluid physics effects on heart function. The automated model is being prepared to fly as a GAS payload. The experimental apparatus consists of a pneumatically actuated, elliptical artificial ventricle connected to a closed-loop, hydraulic circuit with compliance and resistance elements to create physiologic pressure and flow conditions. The ventricle is instrumented with high-fidelity, acceleration-insensitive, catheter-tip pressure transducers (Millar Instruments) in the apex and base to determine the instantaneous ventricular pressures and (delta)P(sub LV) across the left ventricle (LVP(sub apex)-LVP(sub base). The ventricle is also instrumented with a flow probe and pressure transducers immediately upstream of the inflow valve and downstream of the outflow valve. The experiment will be microprocessor controlled with analog signals stored on the FM data tape recorder. By varying the circulating fluid volume, ventricular function can be determined for varying preload pressures with fixed afterload pressure. Pilot experiments on board the NASA KC-135 aircraft have demonstrated proof-of-concept and provided early support for the proposed hypothesis. A review of the pilot experiments and developmental progress on the GAS version of this experiment will be presented.