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At least 37 records · Page 2

Exercise with prebreathe appears to increase protection from decompression sickness: Preliminary findings

Extravehicular activity (EVA) from the Space Shuttle involves one hour of prebreath with 100% oxygen, decompression of the entire Shuttle to 10.2 psia for at least 12 hours, and another prebreath for 40 minutes before decompression to the 4.3 psia suit pressure. We are investigating the use of a one-hour prebreathe with 100% oxygen beginning with a ten-minute strenuous exercise period as an alternative for the staged decompression schedule described above. The 10-minute exercise consists of dual-cycle ergometry performed at 75% of the subject's peak oxygen uptake to increase denitrogenation efficiency by increasing ventilation and perfusion. The control exposures were preceded by a one-hour prebreathe with 100% oxygen while resting in a supine position. The twenty-two male subjects were exposed to 4.3 psia for 4 hours while performing light to moderate exercise. Preliminary results from 22 of the planned 26 subjects indicate 76% DCS following supine, resting prebreathe and 38% following prebreathe with exercise. The staged decompression schedule has been shown to result in 23% DCS which is not significantly different from the exercise-enhanced prebreathe results. Prebreathe including exercise appears to be comparable to the protection afforded by the more lengthy staged decompression schedule. Completion of the study later this year will enable planned statistical analysis of the results.

Webb, James T.↗

Role of Inflammatory Reponse in Experimental Decompression Sickness

Decompression to altitude can result in gas bubble formation both in tissues and in the systemic veins. The venous gas emboli (VGE) are often monitored during decompression exposures to assess risk for decompression sickness (DCS). Astronauts are at risk for DCS during extravehicular activities (EVA), where decompression occurs from the Space Shuttle or Space Station atmospheric pressure of 14.7 pounds per square inch (PSI) to that of the space suit pressure of 4.3 PSI. DCS symptoms include diffuse pain, especially around joints, inflammation and edema. Pathophysiological effects include interstitial inflammatory responses and recurring injury to the vascular endothelium. Such responses can result in vasoconstriction and associated hemodynamic changes.The granulocyte cell activation and chemotaxin release results in the formation of vasoactive and microvascular permeability altering mediators, especially from the lungs which are the principal target organ for the venous bubbles, and from activated cells (neutrophils, platelets, macrophages). Such mediators include free arachidonic acid and the byproducts of its metabolism via the cyclooxygenase and lipoxygenase pathways (see figure). The cyclooxygenase pathway results in formation of prostacyclin and other prostaglandins and thromboxanes that cause vasoconstriction, bronchoconstriction and platelet aggregation. Leukotrienes produced by the alternate pathway cause pulmonary and bronchial smooth muscle contraction and edema. Substances directly affecting vascular tone such as nitric oxide may also play a role in the respose to DCS. We are studying the role and consequent effects of the release inflammatory bioactive mediators as a result of DCS and VGE. More recent efforts are focused on identifying the effects of the body's circadian rhythm on these physiological consequences to decompression stress. al

Butler, B. D.↗

Probability of Decompression Sickness and Venous Gas Emboli from 49 NASA Hypobaric Chamber Tests with Reference to Exploration Atmosphere

Introduction: Decompression sickness (DCS) is a complex biophysical event; it combines human perception of pain, for instance, and the presence of a gas phase in the tissues. Living tissues are complex and dynamic. Micronuclei and later bubbles may or may not form given what appears to be the same conditions. Even when bubbles grow, symptoms may or may not develop under what appears to be the same conditions. Therefore, at this time it is appropriate to consider DCS as a probabilistic rather than a deterministic event. Methods: Probabilistic models about hypobaric DCS and venous gas emboli (VGE) require a large amount of quality research data, a definition of decompression dose using physical and physiologic variables, and a flexible analytical approach that can quantify the association between each outcome and all covariates of interest (assuming independence between DCS and VGE) and then ultimately be extended to acknowledge dependencies between DCS and VGE. Our DCS and VGE data are from 1,031 hypobaric decompressions from 1983 to 2016. A total of 577 humans participated in 49 hypobaric chamber tests to evaluate denitrogenation procedures used by astronauts in the Space Shuttle and International Space Station programs. We defined decompression dose as the ratio of computed nitrogen tension in a theoretical 360-minute half-time compartment to ambient pressure, which accounts for denitrogenation and exposure pressure as well as explanatory variables such as age, sex, body mass index, and the presence or absence of ambulation as part of exercise at the exposure pressure. A parametric survival model, using a log-logistic distribution, was used to quantify the time to development of DCS, VGE, and Grade IV VGE. Results: Our survival estimates are applicable to simple hypobaric decompressions, such as depressurizations in 5 to 30 minutes to exposure pressures between 4 and 10 pounds per square inch absolute (psia) and after minutes to hours of denitrogenation, either under resting or exercise conditions to accelerated denitrogenation. The regressions are applicable to exposures between 2 to 6 hours and under conditions of ambulation or no ambulation as part of exercise at the test pressure. We estimate that an exposure to 4.3 psia with simulated extravehicular activity (EVA) that includes ambulation after equilibration to the exploration atmosphere at 8.2 psia with a 34% oxygen atmosphere will result in 3.1% DCS (1.8% to 5.2 95% confidence interval), 23.2% VGE (16.7 to 31.2%), and 8.5% Grade IV VGE (4.7 to 14.7%) in equal samples of men and women exposed for 6 hours. Discussion: Probabilistic models for DCS, VGE, and Grade IV VGE can be used to inform those that plan future EVAs. Their applications are useful to quantify the risk of DCS and VGE in astronauts that perform EVAs in low-pressure space suits while in space or while exploring the surfaces of the moon or Mars.

Johnny Conkin↗

Decompression-Driven Superconductivity Enhancement in In 2 Se 3

An unexpected superconductivity enhancement is reported in decompressed In 2 Se 3 . The onset of superconductivity in In 2 Se 3 occurs at 41.3 GPa with a critical temperature (T c ) of 3.7 K, peaking at 47.1 GPa. The striking observation shows that this layered chalcogenide remains superconducting in decompression down to 10.7 GPa. More surprisingly, the highest T c that occurs at lower decompression pressures is 8.2 K, a twofold increase in the same crystal structure as in compression. It is found that the evolution of T c is driven by the pressure-induced R-3m to I-43d structural transition and significant softening of phonons and gentle variation of carrier concentration combined in the pressure quench. The novel decompression-induced superconductivity enhancement implies that it is possible to maintain pressure-induced superconductivity at lower or even ambient pressures with better superconducting performance.

36 MATERIALS SCIENCE↗

A Log Logistic Survival Model Applied to Hypobaric Decompression Sickness

Decompression sickness (DCS) is a complex, multivariable problem. A mathematical description or model of the likelihood of DCS requires a large amount of quality research data, ideas on how to define a decompression dose using physical and physiological variables, and an appropriate analytical approach. It also requires a high-performance computer with specialized software. I have used published DCS data to develop my decompression doses, which are variants of equilibrium expressions for evolved gas plus other explanatory variables. My analytical approach is survival analysis, where the time of DCS occurrence is modeled. My conclusions can be applied to simple hypobaric decompressions - ascents lasting from 5 to 30 minutes - and, after minutes to hours, to denitrogenation (prebreathing). They are also applicable to long or short exposures, and can be used whether the sufferer of DCS is at rest or exercising at altitude. Ultimately I would like my models to be applied to astronauts to reduce the risk of DCS during spacewalks, as well as to future spaceflight crews on the Moon and Mars.

Conkin, Johnny↗

The Susceptibility of Juvenile American Shad to Rapid Decompression and Fluid Shear Exposure Associated with Simulated Hydroturbine Passage

Throughout many areas of their native range, American shad (Alosa sapidissima) and other Alosine populations are in decline. Though several conditions have influenced these declines, hydropower facilities have had significant negative effects on American shad populations. Hydropower facilities expose ocean-migrating American shad to physical stressors during passage through hydropower facilities, including strike, rapid decompression, and fluid shear. In this laboratory-based study, juvenile American shad were exposed separately to rapid decompression and fluid shear to determine their susceptibility to these stressors and develop dose–response models. These dose–response relationships can help guide the development and/or operation of hydropower turbines and facilities to reduce the negative effects to American shad. Relative to other species, juvenile American shad have a high susceptibility to both rapid decompression and fluid shear. Reducing or preventing exposure to these stressors at hydropower facilities may be a potential method to assist in the effort to restore American shad populations.

13 HYDRO ENERGY↗

Age affects severity of venous gas emboli on decompression from 14.7 to 4.3 psia

INTRODUCTION: Variables that define who we are, such as age, weight and fitness level influence the risk of decompression sickness (DCS) and venous gas emboli (VGE) from diving and aviation decompressions. We focus on age since astronauts that perform space walks are approximately 10 yr older than our test subjects. Our null hypothesis is that age is not statistically associated with the VGE outcomes from decompression to 4.3 psia. METHODS: Our data are from 7 different NASA tests where 188 men and 50 women performed light exercise at 4.3 psia for planned exposures no less than 4 h. Prebreathe (PB) time on 100% oxygen ranged from 150-270 min, including ascent time, with exercise of different intensity and length being performed during the PB in four of the seven tests with 150 min of PB. Subjects were monitored for VGE in the pulmonary artery using a Doppler ultrasound bubble detector for a 4-min period every 12 min. There were six design variables; the presence or absence of lower body adynamia and five PB variables; plus five concomitant variables on physical characteristics: age, weight height, body mass index, and gender that were available for logistic regression (LR). We used LR models for the probability of DCS and VGE, and multinomial logit (ML) models for the probability of Spencer VGE Grades 0-IV at exposure times of 61, 95, 131, 183 min, and for the entire exposure. RESULTS: Age was significantly associated with VGE in both the LR and ML models, so we reject the null hypothesis. Lower body adynamia was significant for all responses. CONCLUSIONS: Our selection of tests produced a wide range of the explanatory variables, but only age, lower body adynamia, height, and total PB time was helpful in various combinations to model the probability of DCS and VGE.

Clinical Trial↗

How low can they go when going with the flow? Tolerance of egg and larval fishes to rapid decompression

Egg and larval fish that drift downstream are likely to encounter river infrastructure and consequently rapid decompression, which may result in significant injury. In juvenile fish, pressure-related injury (or barotrauma) occurs when pressures fall sufficiently below the pressure at which the fish has acclimated. Because eggs and larvae are less-developed and more fragile than juveniles, there is a presumption that they may be at least as, if not more, susceptible to barotrauma injury, but studies to date report inconsistent results and none have considered the relationship between pressure change and barotrauma over a sufficiently broad range of pressure changes to enable detrimental levels to be properly determined. To address this, we exposed eggs and larvae of three physoclistic species to rapid decompression in a barometric chamber over a broad range of discrete pressure changes. Eggs, but not larvae, were unaffected by all levels of decompression tested. At exposure pressures below ~40 kPa, or ~40% of atmospheric pressure, swim bladder deflation occurred in all species and internal haemorrhage was observed in one species. None of these injuries killed the fish within 24 hours, but subsequent mortality cannot be excluded. Consequently, if larval drift is expected, it seems prudent to maintain exposure pressures at river infrastructure at 40% or more of the pressure to which a drifting larvae has acclimated.

break-point analysis↗

A review of the influence of physical condition parameters on a typical aerospace stress effect: Decompression sickness

The study examines data on episodes of decompression sickness, particularly from recent Navy work in which the event occurred under multiple stress conditions, to determine the extent to which decompression sickness might be predicted on the basis of personal characteristics such as age, weight, and physical condition. Such information should ultimately be useful for establishing medical selection criteria to screen individuals prior to participation inactivities involving extensive changes in ambient pressure, including those encountered in space operations. The main conclusions were as follows. There is a definite and positive relationship between increasing age and weight and the likelihood of decompression sickness. However, for predictive purposes, the relationship is low. To reduce the risk of bends, particularly for older individuals, strenuous exercise should be avoided immediately after ambient pressure changes. Temperatures should be kept at the low end of the comfort zone. For space activities, pressure changes of over 6-7 psi should be avoided. Prospective participants in future missions such as the Space Shuttle should not be excluded on the basis of age, certainly to age 60, if their general condition is reasonably good and they are not grossly obese. (Modified author abstract)

West, V. R.↗

Decompression sickness in simulated Apollo-Soyuz space missions

Apollo-Soyuz docking module atmospheres were evaluated for incidence of decompression sickness in men simulating passage from the Russian spacecraft atmosphere, to the U.S. spacecraft atmosphere, and then to the American space suit pressure. Following 8 hr of 'shirtsleeve' exposure to 31:69::O2:N2 gas breathing mixture, at 10 psia, subjects were 'denitrogenated' for either 30 or 60 min with 100% O2 prior to decompression directly to 3.7 psia suit equivalent while performing exercise at fixed intervals. Five of 21 subjects experienced symptoms of decompression sickness after 60 min of denitrogenation compared to 6 among 20 subjects after 30 min of denitrogenation. A condition of Grade I bends was reported after 60 min of denitrogenation, and 3 of these 5 subjects noted the disappearance of all symptoms of bends at 3.7 psia. After 30 min of denitrogenation, 2 out of 6 subjects developed Grade II bends at 3.7 psia.

Cooke, J. P.↗

Decompression sickness and venous gas emboli at 8.3 psia

This study sought to determine the bends risk on decompression from sea level to 8.3 psia. On the basis of several prior studies by NASA and the Air Force, this differential was expected to result in a minimal (about 5 percent) incidence of mild decompression sickness, and may be the pressure of choice for the next-generation NASA extravehicular activity (EVA) pressure suit. Thirty-one volunteer subjects, performing light work characteristic of EVA, were exposed to 8.3 psia pressure altitude for six hours. Limb bends incidence was 3.2 percent, and 25.8 percent of the subjects demonstrated significant intravascular bubbling. Those who bubbled were significantly older than the bubble-free group, but differed in no other aspect. An 8.3 psia advanced pressure suit design was considered insufficient to totally preclude the risk of decompression sickness.

Smead, Kenneth W.↗

A computerized databank of decompression sickness incidence in altitude chambers

This report describes a hypobaric decompression sickness databank (HDSD) for use with personal computers. The databank consolidates some of the decompression sickness (DCS) information that has accumulated from altitude chamber tests from 1942 to the present. The information was transcribed to a data collection form, screened for accuracy and duplication, and then added to the databank through a computer keyboard. The databank consists of two files; 63 fields contain details of the test conditions in the altitude chamber, the outcome of the test in terms of DCS and venous gas emboli, the physical characteristics of the group of subjects who underwent the test, and the denitrogenation procedures prior to decompression. The HDSD currently contains 378 records that represent 130,012 altitude exposures from 80 sources: scientific journal articles, government and contractor reports, and chapters from books.

Conkin, Johnny↗

The influence of prior exercise at anaerobic threshold on decompression sickness

This study was conducted to examine the effects of exercise prior to decompression on the incidence of altitude decompression sickness (DCS). In a balanced, two-period, crossover trial, 39 healthy individuals were each exposed twice, without denitrogenation, to an altitude of 6400 m in a hypobaric chamber. Under the experimental condition, subjects exercised at their predetermined anaerobic threshold levels for 30 min each day for 3 d prior to altitude exposure; the other condition was a non-exercise control. Under both conditions, subjects performed exercise simulating space extravehicular activities at altitude for a period of 3 h, while breathing 100 percent oxygen. There were nine preferences (untied responses) for DCS, four under control and five under experimental conditions; all were Type I, pain-only bends. No carry-over effects between exposures was detected, and the test for treatment differences showed p = 0.56 for symptoms. No significant difference in DCS preferences was found after subjects exercised up to their anaerobic threshold levels during the days prior to decompression.

Kumar, K. V.↗

Joint pain and Doppler-detectable bubbles in altitude (Hypobaric) decompression

The observation that altitude decompression sickness (DCS) is associated with pain in the lower extremities is not new, although it is not a consistent finding. DCS in divers is generally in the upper body, an effect often attributed to non-loading of the body while immersed. In caisson workers, DCS is reported more in the lower extremities. Surprisingly, many researchers do not mention the location of DCS joint pain, apparently considering it to be random. This is not the case for the tissue ratios encountered in studying decompression associated with simulated EVA. In NASA/JSC tests, altitude DCS generally presented first in either the ankle, knee, or hip (83 percent = 73/88). There was a definite statistical relation between the maximum Spencer precordial Doppler Grade and the incidence of DCS in the extremity, although this is not meant to imply a casual relation between circulating gas bubbles and joint pain. The risk of DCS with Grade 4 was considerably higher than that of Grades 0 to 3. The DCS risk was independent of the 'tissue ratio.' There was a predominance of lower extremity DCS even when exercise was performed with the upper body. The reason for these locations we hypothesize to be attributed to the formation of tissue gas micronuclei from kinetic and tensile forces (stress-assisted nucleation) and are the result of the individuals ambulating in a 1g environment. Additionally, since these showers of Doppler bubbles can persist for hours, it is difficult to imagine that they are emanating solely from tendons and ligaments, the supposed site of joint pain. This follows from Henry's law linking the volume of joint tissue (the solvent) and the solubility coefficient of inert gas; there is volumetrically insufficient connective tissue to produce the prolonged release of gas bubbles. If gas bubbles are spawned and released from connective tissue, their volume is increased by those from muscle tissue. Therefore, the nexus between Doppler-detectable gas bubbles and joint-pain decompression sickness is essentially a statistical, rather than a direct, one.

Powell, Michael R.↗

Gender and Decompression Sickness: A Critical Review and Analysis

The author addressed the following questions: are women at greater risk of decompression sickness and venous gas emboli at certain times in their reproductive cycle, is risk modified by the use of birth control pills (BCP), and is there a difference in overall risk between men and women under the same decompression dose? The summary considers information from the few abstracts and reports that were available. Except for the observation of more Type II DCS in women, particularly in women who fly after diving, there was no compelling evidence of a difference in DCS risk between men and women SCUBA divers. Many women that presented with DCS symptoms seemed to be in or near menses, with statistically fewer cases reported as time increased from menses. There was no compelling evidence that the use of BCP in SCUBA divers increases the risk of DCS. There were insufficient data about VGE from SCUBA diving to make any conclusion about the incidence of VGE and gender. In contrast, there were ample data about VGE from research in altitude chambers. Women produced less VGE and less Grade IV VGE compared to men under the same decompression dose, certainly when resting oxygen prebreathe (PB) was performed prior to ascent to altitude. Dual-cycle ergometry exercise during PB tends to reduce the differences in VGE between men and women. There was no compelling evidence that the risk of altitude DCS was different between men and women. However, a large number of DCS cases were associated with menses, and the use of BCP did seem to put women at a slightly greater risk than those that did not use BCP. There were substantial observations that women comprised a larger number of difficult cases that required complicated medical management.

Source record↗

Description of the NASA Hypobaric Decompression Sickness Database (1982-1998)

The availability of high-speed computers, data analysis software, and internet communication are compelling reasons to describe and make available computer databases from many disciplines. Methods: Human research using hypobaric chambers to understand and then prevent decompression sickness (DCS) during space walks has been conducted at the Johnson Space Center (JSC) from 1982 to 1998. The data are archived in the NASA Hypobaric Decompression Sickness Database, within an Access 2003 Relational Database. Results: There are 548 records from 237 individuals that participated in 31 unique tests. Each record includes physical characteristics, the denitrogenation procedure that was tested, and the outcome of the test, such as the report of a DCS symptom and the intensity of venous gas emboli (VGE) detected with an ultrasound Doppler bubble detector as they travel in the venous blood along the pulmonary artery on the way to the lungs. We documented 84 cases of DCS and 226 cases where VGE were detected. The test altitudes were 10.2, 10.1, 6.5, 6.0, and 4.3 pounds per square inch absolute (psia). 346 records are from tests conducted at 4.3 psia, the operating pressure of the current U.S. space suit. 169 records evaluate the Staged 10.2 psia Decompression Protocol used by the Space Shuttle Program. The mean exposure time at altitude was 242.3 minutes (SD = 80.6), with a range from 120 to 360 minutes. Among our test subjects, 96 records of exposures are females. The mean age of all test subjects was 31.8 years (SD = 7.17), with a range from 20 to 54 years. Discussion: These data combined with other published databases and evaluated with metaanalysis techniques would extend our understanding about DCS. A better understanding about the cause and prevention of DCS would benefit astronauts, aviators, and divers.

Wessel, J. H., III↗

Musculoskeletal-induced Nucleation in Altitude Decompression Sickness

Musculoskeletal activity has the potential to both improve and compromise decompression safety. Exercise enhances inert gas elimination during oxygen breathing prior to decompression (prebreathe), but it may also promote bubble nuclei formation (nucleation), which can lead to gas phase separation and bubble growth and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of musculoskeletal activity and the level of tissue supersaturation may be critical to the net effect. There are limited data available to evaluate cost-benefit relationships. Understanding the relationship is important to improve our understanding of the underlying mechanisms of nucleation in exercise prebreathe protocols and to quantify risk in gravity and microgravity environments. Data gathered during NASA's Prebreathe Reduction Program (PRP) studies combined oxygen prebreathe and exercise followed by low pressure (4.3 psi; altitude equivalent of 30,300 ft [9,235 m]) microgravity simulation to produce two protocols used by astronauts preparing for extravehicular activity. Both the Phase II/CEVIS (cycle ergometer vibration isolation system) and ISLE (in-suit light exercise) trials eliminated ambulation to more closely simulate the microgravity environment. The CEVIS results (35 male, 10 female) serve as control data for this NASA/Duke study to investigate the influence of ambulation exercise on bubble formation and the subsequent risk of DCS.

Pollock, N. W.↗

Ambulation During Periods of Supersaturation Increase Decompression Stress in Spacewalk Simulations

Musculoskeletal activity accelerates inert gas elimination during oxygen breathing prior to decompression (prebreathe), but may also promote bubble formation (nucleation) and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of musculoskeletal activity and the level of tissue supersaturation are likely critical to the net effect. Understanding the relationships is important to evaluate exercise prebreathe protocols and quantify decompression risk in gravity and microgravity environments. The NASA Prebreathe Reduction Program (PRP) combined oxygen prebreathe and exercise preceding a low pressure (4.3 psia; altitude equivalent of 30,300 ft [9,235 m]) simulation exposure of non-ambulatory subjects (a microgravity analog) to produce two protocols now used by astronauts preparing for extravehicular activity. One protocol included both upright cycling and non-cycling exercise (CEVIS: 'cycle ergometer vibration isolation system') and one protocol relied on non-cycling exercise only (ISLE: 'in-suit light exercise'). CEVIS trial data serve as control data for the current study to investigate the influence of ambulation exercise in 1G environments on bubble formation and the subsequent risk of DCS.

Pollock, N. W.↗