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The development of an engineering prototype of a life support system is discussed. The module consists of an electrocardiogram, a defibrillator, a resuscitator, and an aspirator, as well as body temperature and blood pressure measuring instruments. A drug kit is included.
The ultimate goal of research efforts directed at underload, boredom, or complacency in high-technology work environments is to detect conditions or states of the operator that can be demonstrated to lead to performance degradation, and then to intervene in the environment to restore acceptable system performance. Physiological measures may provide indices of changes in condition or state of the operator that may be of value in high-technology work environments. The focus of the present study was on the use of physiological measures in the assessment of operator condition or state in a task underload scenario. A fault acknowledgement task characterized by simple repetitive responses with minimal novelty, complexity, and uncertainty was employed to place subjects in a task underload situation. Physiological measures (electrocardiogram (ECG), electroencephalogram (EEG), and pupil diameter) were monitored during task performance over a one-hour test session for 12 subjects. Each of the physiological measures exhibited changes over the test session indicative of decrements in subject arousal level. While high correlations between physiological measures were found across subjects, individual differences between subjects support the use of profiling techniques to establish baselines unique to each subject.
Outlined here is the development of neurophysiological procedures to monitor operators during the performance of cognitive tasks. Our approach included the use of electroencepalographic (EEG) and rheoencephalographic (REG) techniques to determine changes in cortical function associated with cognition in the operator's state. A two channel tetrapolar REG, a single channel forearm impedance plethysmograph, a Lead I electrocardiogram (ECG) and a 21 channel EEG were used to measure subject responses to various visual-motor cognitive tasks. Testing, analytical, and display procedures for EEG and REG monitoring were developed that extend the state of the art and provide a valuable tool for the study of cerebral circulatory and neural activity during cognition.
The common mode rejection ratio (CMRR) of the single operational amplifier (op amp) differential amplifier and of the three operational amplifier differential amplifier was investigated. The three op amp differential amplifier circuit is used in the signal conditioner circuit which amplifies signals such as the electromyograph or electrocardiogram. The investigation confirmed via SPICE modeling what has been observed by others in the recent literature that the CMRR for the circuit can be maximized without precision resistor values or precisely matched op amps. This can be done if one resistor in the final stage can be adjusted either by a potentiometer or by laser trimming in the case of hybrid circuit fabrication.
The Rhesus Research Facility (RRF) is a research environment designed to study the effects of microgravity using rhesus primates as human surrogates. This experimental model allows investigators to study numerous aspects of microgravity exposure without compromising crew member activities. Currently, the RRF is slated for two missions to collect its data, the first mission is SLS-3, due to fly in late 1995. The RRF is a joint effort between the United States and France. The science and hardware portions of the project are being shared between the National Aeronautics and Space Administration (NASA) and France's Centre National D'Etudes Spatiales (CNES). The RRF is composed of many different subsystems in order to acquire data, provide life support, environmental enrichment, computer facilities and measurement capabilities for two rhesus primates aboard a nominal sixteen day mission. One of these subsystems is the Rhesus Measurement System (RMS). The RMS is designed to obtain in-flight physiological measurements from sensors interfaced with the subject. The RMS will acquire, preprocess, and transfer the physiologic data to the Flight Data System (FDS) for relay to the ground during flight. The measurements which will be taken by the RMS during the first flight will be respiration, measured at two different sites; electromyogram (EMG) at three different sites; electroencephalogram (EEG); electrocardiogram (ECG); and body temperature. These measurements taken by the RMS will assist the research team in meeting the science objectives of the RRF project.
At presyncopal levels of lower body negative pressure (LBNP), we have frequently observed electrocardiographic responses that may be due to changes in cardiac position and/or shape, but could be indicative of altered myocardial function. To further investigate this, we evaluated cardiac function using a nuclear imaging technique in 21 healthy subjects (17 men and 4 women) after 30 minutes of supine rest and near the end of a presyncopal-limited LBNP exposure (LBNP averaged 65 plus or minus 3 mmHg at injection). Cardiac first pass images were obtained with a Multi-Wire Gamma Camera following an intravenous bolus injection of 30-50 millicurries of Tantalum-178. Manual blood pressures and electrocardiograms were obtained throughout the 3 minute graded LBNP protocol. Between rest and injection during LBNP, heart rate increased (P less than 0.01) from 67 plus or minus 3 beats per minute to 99 plus or minus beats per minute, systolic blood pressure decreased (P less than 0.01) from 110 plus or minus 3 mmHg to 107 plus or minus 3 mmHg and left ventricular ejection fraction (EF) decreased (P less than 0.01) from 0.57 plus or minus 0.02 to 0.48 plus or minus 0.02. During LBNP, ST segment depression of at least 0.5 mm occurred in 7 subjects. Subjects with ST depression had greater reductions (P = 0.05) in EF than subjects without ST depression (0.15 plus or minus 0.07 versus 0.005 plus or minus 0.03), but also tolerated greater levels (P less than 0.05) of negative pressure (88 plus or minus mmHg versus 69 plus or minus 5 mmHg). There was a significant relationship between presyncopal LBNP level and EF (R(exp 2) = 0.50, P less than 0.05). Our findings suggest there may be a decrease in systolic myocardial function at high levels of LBNP.
Eleven anesthetized rhesus monkeys were used to study cardiovascular, renal, and endocrine alterations associated with 120 min of head-out water immersion. Five animals underwent complete intrapericardial denervation using the Randall technique, while the remaining six monkeys served as intact controls. Each animal was chronically instrumented with an electromagnetic flow probe on the ascending aorta, a strain gauge pressure transducer implanted in the apex of the left ventricle (LV), and electrocardiogram leads anchored to the chest wall and LV. During immersion, LV end-diastolic pressure, urine flow, glomerular filtration rate, sodium excretion, and circulating atrial natriuretic peptide (ANP) each increased (P less than 0.05) for intact and denervated monkeys. There were no alterations in free water clearance in either group during immersion, yet fractional excretion of free water increased (P less than 0.05) in the intact monkeys. Plasma renin activity (PRA) decreased (P less than 0.05) during immersion in intact monkeys but not the denervated animals. Plasma vasopressin (PVP) concentration decreased (P less than 0.05) during the first 30 min of immersion in both groups but was not distinguishable from control by 60 min of immersion in denervated monkeys. These data demonstrate that complete cardiac denervation does not block the rise in plasma ANP or prevent the natriuresis associated with head-out water immersion. The suppression of PVP during the first minutes of immersion after complete cardiac denervation suggests that extracardiac sensing mechanisms associated with the induced fluid shifts may be responsible for the findings. water immersion; natriuresis; vasopressin; eardiae denervation; monkey
Eleven anesthetized rhesus monkeys were used to study cardiovascular, renal, and endocrine alterations associated with 120 min of head-out water immersion. Five animals underwent complete intrapericardial denervation using the Randall technique, while the remaining six monkeys served as intact controls. Each animal was chronically instrumented with an electromagnetic flow probe on the ascending aorta, a strain gauge pressure transducer implanted in the apex of the left ventricle (LV), and electrocardiogram leads anchored to the chest wall and LV. During immersion, LV end-diastolic pressure, urine flow, glomerular filtration rate, sodium excretion, and circulating atrial natriuretic peptide (ANP) each increased (P less than 0.05) for intact and denervated monkeys. There were no alterations in free water clearance in either group during immersion, yet fractional excretion of free water increased (P less than 0.05) in the intact monkeys. Plasma renin activity (PRA) decreased (P less than 0.05) during immersion in intact monkeys but not the denervated animals. Plasma vasopressin (PVP) concentration decreased (P less than 0.05) during the first 30 min of immersion in both groups but was not distinguishable from control by 60 min of immersion in denervated monkeys. These data demonstrate that complete cardiac denervation does not block the rise in plasma ANP or prevent the natriuresis associated with head-out water immersion. The suppression of PVP during the first minutes of immersion after complete cardiac denervation suggests that extracardiac sensing mechanisms associated with the induced fluid shifts may be responsible for the findings.
Cambridge Heart, Inc., has licensed the only U.S. Food and Drug Administration-cleared tool to identify those at risk for sudden cardiac death (SCD). The Microvolt T-Wave Alternans Test(TM) was invented by Dr. Richard J. Cohen, a professor at the Harvard-Massachusetts Institute of Technology (MIT) Division of Health Sciences and Technology, with developmental support and funding from NASA's Johnson Space Center and the National Space Biomedical Research Institute (NSBRI) in Houston, Texas. In 1993, MIT licensed the technology to Cambridge Heart, Inc., a start-up company that Dr. Cohen helped to establish. Cambridge Heart's non-invasive technology measures T-wave alternans, a change from one heartbeat to the next that is too minute to be detected by a standard electrocardiogram. Cardiac patients with such a change in heartbeat regulation are faced with a much greater risk of ventricular arrhythmia and SCD than those without it. The company's ability to measure electrical alternans on a microvolt level has been clinically proven to be just as accurate as - and in some studies, more accurate than - more costly and somewhat risky, invasive procedures, such as electrophysiological testing.
Originally developed under contract for NASA by Ball Bros. Research Corporation for acquiring visual information from lunar and planetary spacecraft, system uses standard closed circuit camera connected to a device called a scan converter, which slows the stream of images to match an audio circuit, such as a telephone line. Transmitted to its destination, the image is reconverted by another scan converter and displayed on a monitor. In addition to assist scans, technique allows transmission of x-rays, nuclear scans, ultrasonic imagery, thermograms, electrocardiograms or live views of patient. Also allows conferencing and consultation among medical centers, general practitioners, specialists and disease control centers. Commercialized by Colorado Video, Inc., major employment is in business and industry for teleconferencing, cable TV news, transmission of scientific/engineering data, security, information retrieval, insurance claim adjustment, instructional programs, and remote viewing of advertising layouts, real estate, construction sites or products.
Lewis Research Center helped design the complex EMS Communication System, originating from space operated telemetry, including the telemetry link between ambulances and hospitals for advanced life support services. In emergency medical use telemetry links ambulances and hospitals for advanced life support services and allows transmission of physiological data -- an electrocardiogram from an ambulance to a hospital emergency room where a physician reads the telemetered message and prescribes emergency procedures to ambulance attendants.
The "black bag" is outgrowth of astronaut monitoring technology from NASA's Johnson Space Center. Technically known as the portable medical status system, a highly advanced physician's "black bag" weighs less than 30 pounds, yet contains equipment for monitoring and recording vital signs, electrocardiograms, and electroencephalograms. Liquid crystal displays are used to present 15 digits of data simultaneously for long periods of time without excessive use of battery power. Single printed circuit card contains all circuitry required to measure and display vital signs such as heart and respiration rate, temperature, and blood pressure.
When astronauts return to Earth and stand upright, their heart rates may speed inordinately, their blood pressures may fall, and some returning astronauts may even faint. Since physiological adjustments to standing are mediated importantly by pressure-regulating reflexes (baroreflexes), we studied involuntary (or autonomic) nerve and blood pressure responses of astronauts to four, 15-second periods of 15- and 30-mmHg straining (Valsalva'.~ maneuver). We measured the electrocardiogram, finger blood pressure, respiration, and muscle sympathetic nerve activity in four healthy male astronauts before and during the 16-day Neurolab Space Shuttle mission. We found that although microgravity provoked major autonomic changes, no astronaut experienced fainting symptoms after the mission. Blood pressure fell more during straining in space than on Earth (the average reduction of systolic pressure with 30-mmHg straining was 49 mmHg during and 27 mmHg before the mission). However, the increases of muscle sympathetic nerve activity that were triggered by straining were also larger in space than on Earth. As a result, the gain of the sympathetic baroreflex, taken as the total sympathetic nerve response divided by the maximum pressure reduction during straining, was the same in space as on Earth. In contrast, heart rate changes, which are mediated by changes of vagus nerve activity, were smaller in space. This and earlier research suggest that exposure to microgravity augments blood pressure and sympathetic adjustments to Valsalva straining and differentially reduces vagal, but not sympathetic baroreflex responsiveness. The changes that we documented can be explained economically as a consequence of the blood volume reduction that occurs in space.
Several studies have shown that diminution of the high-frequency (HF; 150-250 Hz) components present within the central portion of the QRS complex of an electrocardiogram (ECG) is a more sensitive indicator for the presence of myocardial ischemia than are changes in the ST segments of the conventional low-frequency ECG. However, until now, no device has been capable of displaying, in real time on a beat-to-beat basis, changes in these HF QRS ECG components in a continuously monitored patient. Although several software programs have been designed to acquire the HF components over the entire QRS interval, such programs have involved laborious off-line calculations and postprocessing, limiting their clinical utility. We describe a personal computer-based ECG software program developed recently at the National Aeronautics and Space Administration (NASA) that acquires, analyzes, and displays HF QRS components in each of the 12 conventional ECG leads in real time. The system also updates these signals and their related derived parameters in real time on a beat-to-beat basis for any chosen monitoring period and simultaneously displays the diagnostic information from the conventional (low-frequency) 12-lead ECG. The real-time NASA HF QRS ECG software is being evaluated currently in multiple clinical settings in North America. We describe its potential usefulness in the diagnosis of myocardial ischemia and coronary artery disease.
OBJECTIVES: This study was designed to evaluate the ability of microvolt-level T-wave alternans (MTWA) to identify prospectively patients with idiopathic dilated cardiomyopathy (DCM) at risk of ventricular tachyarrhythmic events and to compare its predictive accuracy with that of conventional risk stratifiers. BACKGROUND: Patients with DCM are at increased risk of sudden death from ventricular tachyarrhythmias. At present, there are no established methods of assessing this risk. METHODS: A total of 137 patients with DCM underwent risk stratification through assessment of MTWA, left ventricular ejection fraction, baroreflex sensitivity (BRS), heart rate variability, presence of nonsustained ventricular tachycardia (VT), signal-averaged electrocardiogram, and presence of intraventricular conduction defect. The study end point was either sudden death, resuscitated ventricular fibrillation, or documented hemodynamically unstable VT. RESULTS: During an average follow-up of 14 +/- 6 months, MTWA and BRS were significant univariate predictors of ventricular tachyarrhythmic events (p < 0.035 and p < 0.015, respectively). Multivariate Cox regression analysis revealed that only MTWA was a significant predictor. CONCLUSIONS: Microvolt-level T-wave alternans is a powerful independent predictor of ventricular tachyarrhythmic events in patients with DCM.
AIM: Astronauts return to Earth with reduced red cell masses and hypovolaemia. Not surprisingly, when they stand, their heart rates may speed inordinately, their blood pressures may fall, and some may experience frank syncope. We studied autonomic function in six male astronauts (average +/- SEM age: 40 +/- 2 years) before, during, and after the 16-day Neurolab space shuttle mission. METHOD: We recorded electrocardiograms, finger photoplethysmographic arterial pressures, respiration, peroneal nerve muscle sympathetic activity, plasma noradrenaline and noradrenaline kinetics, and cardiac output, and we calculated stroke volume and total peripheral resistance. We perturbed autonomic function before and during spaceflight with graded Valsalva manoeuvres and lower body suction, and before and after the mission with passive upright tilt. RESULTS: In-flight baseline sympathetic nerve activity was increased above pre-flight levels (by 10-33%) in three subjects, in whom noradrenaline spillover and clearance also were increased. Valsalva straining provoked greater reductions of arterial pressure, and proportionally greater sympathetic responses in space than on Earth. Lower body suction elicited greater increases of sympathetic nerve activity, plasma noradrenaline, and noradrenaline spillover in space than on Earth. After the Neurolab mission, left ventricular stroke volume was lower and heart rate was higher during tilt, than before spaceflight. No astronaut experienced orthostatic hypotension or pre-syncope during 10 min of post-flight tilting. CONCLUSION: We conclude that baseline sympathetic outflow, however measured, is higher in space than on earth, and that augmented sympathetic nerve responses to Valsalva straining, lower body suction, and post-flight upright tilt represent normal adjustments to greater haemodynamic stresses associated with hypovolaemia.
We studied heart rate (HR), heart rate variability (HRV), and respiratory sinus arrhythmia (RSA) in four male subjects before, during, and after 16 days of spaceflight. The electrocardiogram and respiration were recorded during two periods of 4 min controlled breathing at 7.5 and 15 breaths/min in standing and supine postures on the ground and in microgravity. Low (LF)- and high (HF)-frequency components of the short-term HRV (< or =3 min) were computed through Fourier spectral analysis of the R-R intervals. Early in microgravity, HR was decreased compared with both standing and supine positions and had returned to the supine value by the end of the flight. In microgravity, overall variability, the LF-to-HF ratio, and RSA amplitude and phase were similar to preflight supine values. Immediately postflight, HR increased by approximately 15% and remained elevated 15 days after landing. LF/HF was increased, suggesting an increased sympathetic control of HR standing. The overall variability and RSA amplitude in supine decreased postflight, suggesting that vagal tone decreased, which coupled with the decrease in RSA phase shift suggests that this was the result of an adaptation of autonomic control of HR to microgravity. In addition, these alterations persisted for at least 15 days after return to normal gravity (1G).
OBJECTIVES: We studied hemodynamic changes leading to orthostatic vasovagal presyncope to determine whether changes of cerebral artery blood flow velocity precede or follow reductions of arterial pressure. BACKGROUND: Some evidence suggests that disordered cerebral autoregulation contributes to the occurrence of orthostatic vasovagal syncope. We studied cerebral hemodynamics with transcranial Doppler recordings, and we closely examined the temporal sequence of changes of cerebral artery blood flow velocity and systemic arterial pressure in 15 patients who did or did not faint during passive 70 degrees head-up tilt. METHODS: We recorded photoplethysmographic arterial pressure, RR intervals (electrocardiogram) and middle cerebral artery blood flow velocities (mean, total, mean/RR interval; Gosling's pulsatility index; and cerebrovascular resistance [mean cerebral velocity/mean arterial pressure, MAP]). RESULTS: Eight men developed presyncope, and six men and one woman did not. Presyncopal patients reported light-headedness, diaphoresis, or a sensation of fatigue 155 s (range: 25 to 414 s) before any cerebral or systemic hemodynamic change. Average cerebral blood flow velocity (CBFV) changes (defined by an iterative linear regression algorithm) began 67 s (range: 9 to 198 s) before reductions of MAP. Cerebral and systemic hemodynamic measurements remained constant in nonsyncopal patients. CONCLUSIONS: Presyncopal symptoms and CBFV changes precede arterial pressure reductions in patients with orthostatic vasovagal syncope. Therefore, changes of cerebrovascular regulation may contribute to the occurrence of vasovagal reactions.