The problem of homeostasis in space medicine
Life support systems and space suits for preserving homeostatic reactions of astronauts
Hazen, I. M.↗
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Certain aspects of the vestibular problem in space medicine
Vestibulovegetative disorders on manned space flights are discussed. A study relating to the vestibular stimuli in respiration, diaphoresis cardiac rhythm and a broad complex of hemodynamic indices was conducted. Certain tests for astronaut candidates are discussed.
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Space medicine
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.
Johnson, P. C., Jr.↗
Space medicine research publications: 1987-1988
A list of publications of investigators supported by the Biomedical Research and Clinical Programs of the Life Sciences Division, Office of Space Science and Applications is given. Included are publications entered into the Life Sciences Bibliographic Database by the George Washington University as of 31 December 1988. Principal Investigators whose research tasks resulted in publication are identified by asterisk. Publications are organized into the following subject areas: space physiology and countermeasures (cardiopulmonary, musculoskeletal, neuroscience, and regulatory physiology), space human factors, environmental health, radiation health, clinical medicine, and general space medicine.
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Incorporating Research Findings into Standards and Requirements for Space Medicine
The Vision for Exploration has been the catalyst for NASA to refocus its life sciences research. In the future, life sciences research funded by NASA will be focused on answering questions that directly impact setting physiological standards and developing effective countermeasures to the undesirable physiological and psychological effects of spaceflight for maintaining the health of the human system. This, in turn, will contribute to the success of exploration class missions. We will show how research will impact setting physiologic standards, such as exposure limits, outcome limits, and accepted performance ranges. We will give examples of how a physiologic standard can eventually be translated into an operational requirement, then a functional requirement, and eventually spaceflight hardware or procedures. This knowledge will be important to the space medicine community as well as to vehicle contractors who, for the first time, must now consider the human system in developing and constructing a vehicle that can achieve the goal of success.
Duncan, J. Michael↗
An overview of the space medicine program and development of the Health Maintenance Facility for Space Station
Because the prolonged stay on board the Space Station will increase the risk of possible inflight medical problems from that on Skylab missions, the Health Maintenance Facility (HMF) planned for the Space Station is much more sophisticated than the small clinics of the Skylab missions. The development of the HMF is directed by the consideration of three primary factors: prevention, diagnosis, and treatment of injuries and illnesses that may occur in flight. The major components of the HMF include the clinical laboratory, pharmacy, imaging system, critical-care system, patient-restraint system, data-management system, exercise system, surgical system, electrophysiologic-monitoring system, introvenous-fluid system, dental system, and hyperbaric-treatment-support system.
Pool, Sam Lee↗
Electroencephalographic studies in space medicine
Electroencephalography for astronaut selection and space flight medical supervision
Gazenko, O. G.↗
Answering the Space Medicine Challenge
The development of the Space Station Health Maintenance Facility (HMF) is featured. The HMF will provide necessary inflight medical care, including prevention, diagnosis, treatment, and care during transport if the patient must be evacuated from Space Station.
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Human Factors in Training - Space Medicine Proficiency Training
The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction ratings were captured.
Connell, Erin↗
Space medicine - Answering the challenge
The development of Space Station Freedom (SSF) Health Maintenance Facility (HMF) is discussed. Attention is given to HMF subsystems; the diagnostic radiological imaging system; the physician instruments; the pharmacy and central supply; the Fluid Therapy Subsystem; the restraints to be used for medical procedures; and the Safe Haven mode, which is a mode of station operation in which it is assumed that the HMF has been lost and the medical needs must be provided by the emergency medical equipment and supplies located in the Portable Emergency Provisions. Special attention is given to the pharmaceutical issues involved, including such as the product selection, oral medications, injectable medications, the effect of exposing medications to high vacuum, and the product shelf life.
Lloyd, Charles W.↗
Cases in Space Medicine: Right Lower Quadrant Abdominal Pain in a Female Crewmember on the International Space Station
A case study of a medical emergency aboard the International Space Station is reviewed. The case involves a female crewmember who is experiencing acute abdominal pain. The interplay of the Crew Medical Officer (CMO) and the NASA Flight Surgeon is given. Possible diagnoses, and advised medical actions are reviewed. Along the case study questions are posed to the reader, and at the end answers are given.
Hamilton, Douglas R.↗
Space Medicine: A Surgeon's Perspective
For the first four decades of human space flight NASA's priorities in life sciences and medical programs have been preventative medicine (astronaut selection and training); assessment of the physiologic effects of microgravity and other unique aspects of space flight, implementation of countermeasures to protect against adverse effects, and amelioration of these adverse effects. Because most of the U.S. space flight experience has been on short duration missions, the need for medical and diagnostic treatment capabilities have been limited.The first long-term crews will arrive on the International Space Station (ISS) in early 2000. This will usher in a new era, an era of sustained human presence in Low Earth Orbit. One of the principal purposes of the ISS program is to increase the knowledge of the effects of long duration space flight on humans, a pre-requisite to future exploration class missions beyond Low Earth Orbit (e.g., a return to the Moon or an exploration of Mars). Areas of particular interest include protection from radiation, muscle atrophy, bone loss, cardiovascular alterations, immune dysfunction, adverse psychological response to hazards and confinement, and neurovestibular alterations. In addition, long duration space flight requires the development of autonomous medical care capabilities, as the distances involved eliminate the possibility of real-time telemedicine or robotic intervention, and prevent a mission abort and a rapid return to Earth. The objectives of this presentation include: 1. A description of the International Space Station project, including its research facilities and on-orbit medical capabilities; 2. An overview of the physiological and medical problems associated with microgravity in space flight; 3. A review of NASA's biomedical research priorities and ongoing work to develop clinical care capabilities for space flight crews (including surgical interventions) and; 4. An overview of current and proposed research priorities for NASA Research Announcements, NASA Space Biomedical Research Institute, Small Business Innovation Research Grant, and other funding sources.
Dawson, David L.↗
Pharmacotherapeutic Aspects of Space Medicine
Medications are used for a wide variety of indications during space flight. For example, astronauts have taken drugs in flight to ameliorate or prevent symptoms of space motion sickness, headache, sleeplessness, backache, nasal congestion, and constipation. Russian cosmonauts reportedly take medications to prevent metabolic disturbances of the myocardium and intestinal flora, and to optimize their work capacity. Although the discomfort associated with some acute responses to microgravity (e.g., space motion sickness) is expected to diminish with length of time in flight, other responses that have delayed onset (e.g., maintaining nutritional status, bone and muscle strength, and perhaps immune response) may affect health and quality of life during longer missions. Therefore, as the duration of space flights increases, the need for treatment with medications is expected to increase accordingly. Medications carried on Space Shuttle missions have varied somewhat from flight to flight, depending on the individual needs of the crewmembers. Medications use during Shuttle flights seems to be more prevalent than during earlier programs, perhaps because drugs are provided in easy-to-use forms. In fact, nearly all medications taken to date have been ingested orally in tablet form. However, given that the oral route may not be ideal for those suffering motion-sickness symptoms, intramuscular and intranasal preparations are being tested. For example, intramuscular administration of promethazine hydrochloride (Phenergan(Registered TradeMark)) has been reported to be more effective in alleviating motion-sickness symptoms. The difficulties involved in conducting definitive studies of drug efficacy during U.S. space flights have been compounded by the absence of a systematic approach to determining which drugs were taken by whom and under what circumstances. The use of some drugs in space has been less efficacious than expected. The onset, intensity, and duration of the response produced by any drug depend upon rates of absorption, distribution, metabolism, and elimination of the drug; space flight-induced changes in blood flow and the function of the gastrointestinal (GI) tract, liver, or kidneys may alter these processes. Another important aspect of clinical efficacy of medications in space is the stability of pharmaceuticals. As the U.S. space program is moving toward extended Space Shuttle flights and beyond, to space station missions and planetary explorations, understanding how space flight affects organ systems and clinical pharmacology is necessary to optimize pharmacotherapeutics in space and ensure adequate safety and health of crewmembers.
Putcha, Lakshmi↗
Space medicine considerations: Skeletal and calcium homeostasis
Based on the information obtained from space missions, particularly Skylab and the longer Salyut missions, it is clear that bone and mineral metabolism is substantially altered during space flight. Calcium balance becomes increasingly more negative throughout the flight, and the bone mineral content of the os calcis declines. The major health hazards associated with skeletal changes include the signs and symptoms of hypercalcemia with rapid bone turnover, the risk of kidney stones because of hypercalciuria, the lengthy recovery of lost bone mass after flight, the possibility of irreversible bone loss (particularly the trabecular bone), the possible effects of metastated calcification in the soft tissues, and the possible increase in fracture potential. For these reasons, major efforts need to be directed toward elucidating the fundamental mechanisms by which bone is lost in space and developing more effective countermeasures to prevent both short-term and long-term complications.
Schneider, Victor B.↗
Urological considerations in space medicine.
Urological problems encountered during the preparation phases of Biosatellite III, flight of Bonny the Space Monkey, are detailed. The solution to each problem is detailed. The catheter system employed, antibiotic coverage used, and bacteria encountered in the urine of the five animals are detailed. Urinary calcium levels in three ground based animals are illustrated. Testicular alterations encountered in all animals are mentioned. It is concluded that space flights of duration beyond nine days may present serious problems of a urological nature.
Cockett, A. T. K.↗
Space medicine
This paper attempts to underscore the importance of continued studies on the effects of space on human physiology. With particular reference to the Space Station, it is pointed out that there are two aspects which are challenging to life scientists: first is the development of a research capability for the life sciences which will be used to conduct investigations necessary to extend the time humans can remain in space; second is the challenge to develop a medical capability to provide prevention, diagnosis, and therapy. A discussion of physiological changes that have been observed in spacecrews follows along the lines of the two aspects mentioned.
Pool, Sam L.↗
Space medicine in project mercury
Medical aspects of Project Mercury including astronaut selection and training, results of laboratory tests and physiological data, and biomedical planning for space flights.
SPACE FLIGHT↗