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The 2020 exploration atmosphere and EVA prebreathe protocol validation will be the first test in elevated oxygen since the Skylab Medical Experiment Altitude Test (SMEAT).
NASA is collaborating with private entities for the development of commercial space vehicles. The Space and Clinical Operations Division was tasked to review the oxygen and respiratory support system and recommend what capabilities, if any, the vehicle should have to support the return of an ill or injured crewmember. The Integrated Medical Model (IMM) was utilized as a data source for the development of these recommendations. The Integrated Medical Model (IMM) was used to simulate a six month, six crew, International Space Station (ISS) mission. Three medical system scenarios were considered based on the availability of (1) oxygen only, (2) oxygen and a ventilator, or (3) neither oxygen nor ventilator. The IMM analysis provided probability estimates of medical events that would require either oxygen or ventilator support. It also provided estimates of crew health, the probability of evacuation, and the probability of loss of crew life secondary to medical events for each of the three medical system scenarios. These IMM outputs were used as objective data to enable evidence‐based decisions regarding oxygen and respiratory support system requirements for commercial crew vehicles. The IMM provides data that may be utilized to support informed decisions regarding the development of medical systems for commercial crew vehicles.
Space motion sickness (SMS) is an important problem for short-duration space flight; 71 percent of STS crewmembers develop SMS symptoms. The search for effective countermeasures and factors that correlate with sensitivity has been extensive. Recently, several investigators have linked aerobic fitness with motion sickness sensitivity in the 1-G or high-G environment. This paper compares the aerobic fitness of 125 Shuttle crewmembers with their SMS symptom category. Aerobic fitness data were obtained from the exercise tolerance test conducted nearest the time of launch. SMS data were derived from the medical debrief summaries. Mean maximum oxygen consumption values for crewmembers in four SMS categories (none, mild, moderate, severe) were 44.55, 44.08, 46.5, and 44.24 ml/kg per min, respectively. Scattergrams with linear regression analysis, comparing aerobic fitness and SMS symptom classification are presented. Correlation coefficients comparing SMS categories vs. aerobic fitness for men and women reveal no definite relationship between the two factors.
Miniature, portable resuscitation system is used during evacuation of patients to medical facilities. A carrying case contains a modified resuscitator head, cylinder of oxygen, two-stage oxygen regulator, low pressure tube, and a mask for mouth and nose.
Experimental data is examined on the study of the influence of the different parameters of the atmosphere on the organism for the purpose of making a physiological determination of the permissible oxygen concentrations in inhabited airtight compartments. The application of high oxygen concentrations for respiration and for medical purposes are considered. Data is presented on the evolution of the atmosphere and of the role of O2 in the process of the evolutionary development of living beings; the influence of an organism of an artificial, high and low oxygen concentration atmospheres; the laws of oxygen permeation into fluid media of the organism; the biological role of inert gases; etc. The relationship between the gas medium of habitation and reactivity of the organism is determined.
Material and configuration testing for the Space Shuttle is mainly at 30 percent oxygen concentration at 70 kPa (10.2 psia). This is the worst case atmosphere during a mission and occurs 10 hours prior to extravehicular activity. The pressure is reduced from the nominal 101 kPa (14.7 paia) and the oxygen concentration is increased to 30 percent for medical reasons to prevent the bends during the extravehicular activity. NASA has tested many materials at 23.8, 25.9 and 30 percent oxygen levels for the Shuttle program. Data is given to show how flammability of material is affected by percentage of oxygen for those materials that would be considered for spacecraft applications.
High purity oxygen is required for a number of scientific, medical, and industrial applications. Traditionally, these needs have been met by cryogenic distillation or pressure swing adsorption systems designed to separate oxygen from air. Oxygen separation from air via solid-state zirconia electrolyte technology offers an alternative to these methods. The technology has several advantages over the traditional methods, including reliability, compactness, quiet operation, high purity output, and low power consumption.
Annual report of the Johnson Space Center Director's Discretionary Fund documenting effective use of resources. The $1,694,000 funding for FY92 was distributed among 27 projects. The projects are an overall aid to the NASA mission, as well as providing development opportunities for the science and engineering staff with eventual spinoff to commercial uses. Projects described include space-based medical research such as the use of stable isotopes of deuterium and oxygen to measure crew energy use and techniques for noninvasive motion sickness medication. Recycling essentials for space crew support is conducted in the Regenerative Life Support and the Hybrid Regenerative Water Recovery test beds. Two-phase fluid flow simulated under low-gravity conditions, hypervelocity particle impact on open mesh bumpers, and microcalorimetry to measure the long-term hydrazine/material compatibility were investigated. A patent application was made on a shape-memory-alloy release nut. Computer estimate of crew accommodations for advanced concepts was demonstrated. Training techniques were evaluated using multimedia and virtual environment. Upgrades of an electronic still camera provide high resolution images from orbit are presented.
In the course of defining the level of risks and mitigating the risks for exploration missions beyond low Earth orbit, NASA s Human Research Program (HRP) has identified the need for technology development in several areas. Long duration missions increase the risk of serious medical conditions due to limited options for return to Earth; no resupply; highly limited mass, power, volume; and communication delays. New space flight compatible medical capabilities required include: diagnostic imaging, oxygen concentrator, ventilator, laboratory analysis (saliva, blood, urine), kidney stone diagnosis & treatment, IV solution preparation and delivery. Maintenance of behavioral health in such an isolated, confined and extreme environment requires new sensory stimulation (e.g., virtual reality) technology. Unobtrusive monitoring of behavioral health and treatment methods are also required. Prolonged exposure to weightlessness deconditions bone, muscle, and the cardiovascular system. Novel exercise equipment or artificial gravity are necessary to prevent deconditioning. Monitoring of the degree of deconditioning is required to ensure that countermeasures are effective. New technologies are required in all the habitable volumes (e.g., suit, capsule, habitat, exploration vehicle, lander) to provide an adequate food system, and to meet human environmental standards for air, water, and surface contamination. Communication delays require the crew to be more autonomous. Onboard decision support tools that assist crew with real-time detection and diagnosis of vehicle and habitat operational anomalies will enable greater autonomy. Multi-use shield systems are required to provide shielding from solar particle events. The HRP is pursuing the development of these technologies in laboratories, flight analog environments and the ISS so that the human health and performance risks will be acceptable with the available resources.
The detection of the first VIIP case occurred in 2005, and adequate eye outcome measures were available for 31 (67.4%) of the 46 long duration US crewmembers who had flown on the ISS since its first crewed mission in 2000. Therefore, this analysis is limited to a subgroup (22 males and 9 females). A "cardiovascular profile" for each astronaut was compiled by examining twelve individual parameters; eleven of these were preflight variables: systolic blood pressure, pulse pressure, body mass index, percentage body fat, LDL, HDL, triglycerides, use of anti‐lipid medication, fasting serum glucose, and maximal oxygen uptake in ml/kg. Each of these variables was averaged across three preflight annual physical exams. Astronaut age prior to the long duration mission, and inflight salt intake was also included in the analysis. The group of cardiovascular variables for each crew member was compared with seven VIIP eye outcome variables collected during the immediate post‐flight period: anterior-posterior axial length of the globe measured by ultrasound and optical biometry; optic nerve sheath diameter, optic nerve diameter, and optic nerve to sheath ratio‐ each measured by ultrasound and magnetic resonance imaging (MRI), intraocular pressure (IOP), change in manifest refraction, mean retinal nerve fiber layer (RNFL) on optical coherence tomography (OCT), and RNFL of the inferior and superior retinal quadrants. Since most of the VIIP eye outcome measures were added sequentially beginning in 2005, as knowledge of the syndrome improved, data were unavailable for 22.0% of the outcome measurements. To address the missing data, we employed multivariate multiple imputation techniques with predictive mean matching methods to accumulate 200 separate imputed datasets for analysis. We were able to impute data for the 22.0% of missing VIIP eye outcomes. We then applied Rubin's rules for collapsing the statistical results across our 200 multiply imputed data sets to assess the canonical correlation between the eye outcomes and the twelve astronaut cardiovascular variables available for all 31 subjects. Results: A highly significant canonical correlation was observed among the canonical solutions (p<.00001), with an average best canonical correlation of.97. The results suggest a strong association between astronauts' measures of cardiovascular health and the seven eye outcomes of the VIIP syndrome used in this analysis. Furthermore, the "joint test" revealed a significant difference in cardiovascular profile between male and female astronauts (Prob > F = 0.00001). Overall, female astronauts demonstrated a significantly healthier cardiovascular status. Individually, the female astronauts had significantly healthier profiles on seven of twelve cardiovascular variables than the men (p values ranging from <0.0001 to <0.05). Male astronauts did not demonstrate significantly healthier values on any of the twelve cardiovascular variables measured
The hydrostatic hyperbaric chamber (HHC) represents the merger of several technologies in development for NASA aerospace applications, harnessed to directly benefit global health. NASA has significant experience developing composite hyperbaric chambers for a variety of applications, including the treatment of medical conditions. NASA also has researched the application of water-filled vessels to increase tolerance of acceleration forces. The combination of these two applications has resulted in the hydrostatic chamber, which has been conceived as a safe, affordable means of making hyperbaric oxygen therapy available in the developing world for the treatment of a variety of medical conditions. Specifically, hyperbaric oxygen therapy is highly-desired as a possibly curative treatment for Buruli Ulcer, an infectious condition that afflicts children in sub-Saharan Africa. Hyperbaric oxygen therapy is simply too expensive and too dangerous to implement in the developing world using standard equipment. The hydrostatic hyperbaric chamber technology changes the paradigm. The HHC differs from standard hyperbaric chambers in that the majority of its volume is filled with water which is pressurized by oxygen being supplied in the portion of the chamber containing the patient s head. This greatly reduces the amount of oxygen required to sustain a hyperbaric atmosphere, thereby making the system more safe and economical to operate. An effort was taken to develop an HHC system to apply HBOT to children that is simple and robust enough to support transport, assembly, maintenance and operation in developing countries. This paper details the concept for an HHC ventilation and pressurization system that will provide controlled pressurization of the system, and provide adequate washout of carbon dioxide while the subject is enclosed in the confined space during the administration of the medical treatment. The concept took into consideration operational complexity, safety to the patient and operating personnel, and physiological considerations. The simple schematic, comprised of easily acquired commercial hardware, supports sustainability.
Modified forming process removes volatile combustible materials. Flammability of cable-wrapping tape reduced by altering tape-manufacturing process. In new manufacturing process, tape formed by proprietary process of screw extrusion, followed by washing in solvent and drying. Tape then wrapped as before. Spectrogram taken after extrusion, washing, and drying shows lower hydrocarbon content. PTFE formed by new process suited to oxygen-rich environments. Safe in liquid oxygen of Space Shuttle tank and in medical uses; thin-wall shrinkable tubing in hospital test equipment, surgical instruments, and implants.
The need for a rapid, inexpensive technique for routine 18O/16O extraction from water has arisen recently through applications in the medical sciences and in hydrology. The traditional experimental technique for determining the oxygen isotope composition of water, the CO2-H2O equilibration method, is tedious, time consuming, and involves the use of custom-made glass apparatus. Furthermore, because of potential memory effects from one sample to the next, the glassware needs to be thoroughly cleaned between runs. A few attempts have been made to improve upon the method. Attempts to analyze water directly in the source of the mass spectrometer produced large memory effects and questionable results. Commercially available apparatus for automated extraction of 18O/16O from water is generally prohibitively expensive and often is designed to interface only with the manufacturer's own mass spectrometer. The method described in this paper utilizes inexpensive, off-the-shelf, preevacuated, glass vials. Preevacuated vials have been used by others for the isotopic analysis of breath CO2 and are well tested. The vials can be purchased in bulk from scientific apparatus suppliers at a relatively low cost. These are coupled with a simplified extraction line consisting of a stainless steel syringe needle and a glass cold trap. Vials are filled with CO2 and H2O and shaken in a constant-temperature water bath for at least 90 min. Since the vials are discarded after use, no cleaning is necessary, essentially eliminating any memory effect. Reproducibility is generally better than +/- 0.05%. The only reagents required are gaseous CO2 for equilibration, a dry ice/alcohol mixture for trapping water, and liquid nitrogen for transferring the CO2.
Dr. Jonathan B. Clark is an adjunct Associate Professor of Neurology and Space Medicine at Baylor College of Medicine. From 1997 to 2005, he worked at NASA as a six-time Space Shuttle crew surgeon and was chief of the Medical Operations Branch at the Johnson Space Center. During this event, Dr. Clark discussed the hazards of low oxygen partial pressure (hypoxia) and high CO2 concentration (hypercarbia). This is one event of a medical series delivered to the SKC Program by Dr. Clark. This series focuses on spacesuit medical lessons learned and medical safety aspects of the suit.
INTRODUCTION The Exploration Medical Capability (ExMC) element within the Human Research Program and the Exploration Medical Integrated Product Team (XMIPT) within the Mars Campaign Office seek to advance medical system design and risk-informed decision-making for exploration missions. This includes assessment of candidate devices and their compatibility within a variety of increasingly Earth-independent medical scenarios. The Tempus Pro (Remote Diagnostic Technologies, Ltd., Philips Corp., Farnborough, UK) is a commercial-off-the-shelf (COTS), multi-functional integrated medical device capable of vital signs monitoring, with built-in procedure support (iAssist), patient record and telemedicine communication features, and medical imaging (e.g., camera, laryngoscope, ultrasound) that meets multiple exploration medical capability needs. One of several hypobaric atmospheres being considered for exploration vehicles is 8.2 psi with 34% oxygen. To assess the useability of the Tempus Pro in such environments by individuals without formal medical training, the unit was tested in May and June of 2023 at the Johnson Space Center 20-Foot Exploration Atmosphere Chamber in conjunction with the Exploration Atmospheres-2 (EA-2) study. TECHNOLOGY DEMONSTRATION Eight subjects in the EA-2 study were assigned roles as the caregiver or patient – or both in the case of a self-exam – and caregivers were asked to place sensors for 3-Lead ECG, non-invasive blood pressure (NIBP), pulse oximetry (SpO2), and temperature using Tempus Pro’s iAssist. Depending on the procedure, additional tasks included an oropharyngeal exam of the throat with the laryngoscope and capturing ultrasound images of a cardiac subxiphoid view or of the user’s choice from a pre-specified list. Scenarios ranged from remote-guided to fully autonomous operations and surveyed the effectiveness of support, amount of support desired, and importance of support by type (e.g., written crew procedures, iAssist and device guidance, remote console guidance, etc.). Feedback from the subjects and the support personnel was also gathered to inform future designs for training and support and to determine what operations are plausible given different levels of each. An unweighted NASA task load index (TLX) was used to profile the demands of using the device, however the sample size does not support statistics. The research was exploratory in nature and qualitative information was the main goal. Calibration checks on the Tempus Pro were conducted before and after chamber testing to ensure the device was in useable condition. RESULTS All subjects performed their tasks successfully and found the Tempus Pro easy to use with the support provided. The calibration checks outside the chamber showed that the Tempus Pro remained unchanged and measurements inside the chamber were within normal values. Caregivers taking the NASA TLX reported mean scores ≤ 41/100 showing the tasks to be undemanding and less demanding with repeated use (~20/100). Novice users were able to easily connect sensors and take vital signs with the guidance from Tempus Pro’s iAssist feature. For more complex tasks, such as the oropharyngeal exam and ultrasound image acquisition, guidance beyond iAssist was needed, primarily from a supporting physician. Feedback on the importance of support types varied by person and scenario but greater than 50% of the support used by each was non-native to the device. Overall opinions were positive, but the ultrasound users expressed a lack of confidence in their results and 3 out of 4 desired more time, training, or support. Subjects found the sensors to be comfortable and comparable to prior experiences with such devices, except for the blood pressure cuff, which squeezed too tightly for uncomfortably long periods. Many observations provoked discussion, especially regarding ultrasound, that will aide decisions about future demonstrations.
A 56-day chamber simulation of Skylab was successfully completed. The atmosphere (5 psi, 70 percent oxygen, 30 percent nitrogen, 5 mm carbon dioxide) and medical features including a 21-day pre- and 18-day post-test medical protocols were closely simulated. No apparent crew health problems were induced by the atmosphere, semiclosed environment, or other test features; and no appreciable crew degradation appeared over this period. The chamber and associated systems performed without major problems.
Proposed calibration standard for mass flow rate of oxygen based on conduction of oxygen ions through solid electrolyte membrane made of zirconia and heated to temperature of 1,000 degrees C. Flow of oxygen ions proportional to applied electric current. Unaffected by variations in temperature and pressure, and requires no measurement of volume. Calibration cell based on concept used to calibrate variety of medical and scientific instruments required to operate with precise rates of flow of oxygen.
The Respiratory Support Pack (RSP) is a medical pack onboard the International Space Station (ISS) that contains much of the necessary equipment for providing aid to a conscious or unconscious crewmember in respiratory distress. Inside the RSP lid pocket is a 5.5 by 11 inch paper procedural cue card, which is used by a Crew Medical Officer (CMO) to set up the equipment and deliver oxygen to a crewmember. In training, crewmembers expressed concerns about the readability and usability of the cue card; consequently, updating the cue card was prioritized as an activity to be completed. The Usability Testing and Analysis Facility at the Johnson Space Center (JSC) evaluated the original layout of the cue card, and proposed several new cue card designs based on human factors principles. The approach taken for the assessment was an iterative process. First, in order to completely understand the issues with the RSP cue card, crewmember post training comments regarding the RSP cue card were taken into consideration. Over the course of the iterative process, the procedural information was reorganized into a linear flow after the removal of irrelevant (non-emergency) content. Pictures, color coding, and borders were added to highlight key components in the RSP to aid in quickly identifying those components. There were minimal changes to the actual text content. Three studies were conducted using non-medically trained JSC personnel (total of 34 participants). Non-medically trained personnel participated in order to approximate a scenario of limited CMO exposure to the RSP equipment and training (which can occur six months prior to the mission). In each study, participants were asked to perform two respiratory distress scenarios using one of the cue card designs to simulate resuscitation (using a mannequin along with the hardware). Procedure completion time, errors, and subjective ratings were recorded. The last iteration of the cue card featured a schematic of the RSP, colors, borders, and simplification of the flow of information. The time to complete the RSP procedure was reduced by approximately three minutes with the new design. In an emergency situation, three minutes significantly increases the probability of saving a life. In addition, participants showed the highest preference for this design. The results of the studies and the new design were presented to a focus group of astronauts, flight surgeons, medical trainers, and procedures personnel. The final cue card was presented to a medical control board and approved for flight. The revised RSP cue card is currently onboard ISS.