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All sourcesNASA NTRSDOE OSTI
NASA NTRS1976

Denitrogenation interruptions with air

A 3-h denitrogenation period at ground-level pressure with 95% O2-5% N2, with an air interruption of 5 min or more and matched with additional denitrogenation time equal to the interruption, will later result occasionally in altitude decompression sickness ('bends') during a 2-h decompression exposure at 3.8 psia (10,058 m equivalent) with 92% O2- 8% N2. Thus the equal time or 'mirror-image' make-up time for loss of denitrogenation did not prevent bends 7 times in 17 subjects during 71 exposures with air interruptions; on the other hand, no case of bends was reported after uninterrupted denitrogenation periods. Nitrogen-loading during the interruptive period is believed to resupply the bends sites with additional nitrogen, which re-establishes conditions favoring a return to a high incidence of bends.

Cooke, J. P.↗
NASA NTRSDate not supplied

Nasa Exploration Atmosphere Tests 3 & 4: Development and Validation of Planetary Extravehicular Activity Prebreathe Protocols for Alternate Atmospheres and Suit Pressures

INTRODUCTION: Space suits operate at low pressures to optimize astronauts’ performance. The drop in pressure from the habitat environment to the suit carries a risk of decompression sickness (DCS), which is mitigated by a 95% O2 prebreathe protocol. Prebreathe protocols for the lunar surface have a significantly higher risk compared to International Space Station microgravity Extravehicular Activities (EVA). In previous studies, we validated a prebreathe protocol from a 56.5 kPa 34% O2 cabin to a 29.6 kPa EVA pressure; however, the enriched oxygen cabin environment poses a flammability risk that requires significant changes to material design and selections. Here, we report outcomes for prebreathe protocols from a sub-30% O2 cabin and associated changes necessary to control DCS risk critical to upcoming lunar missions. METHODS: Fourteen volunteers completed 11-day hypobaric chamber studies with an “alternate exploration atmosphere” of 66.2kPa, 28.5% O2. Subjects acclimated for 48 hrs and then participated in five 6-hour simulated EVAs at 29.6 or 35.6kPa, 95% O2. Prior to EVA, subjects underwent a 20, 90, or 150-minute prebreathe. The EVA simulation was designed to be representative of future planetary EVAs, proportionate to the subject’s VO2max. Decompression stress was monitored by real-time doppler and echocardiograph alternating every 15 min, as well as clinical monitoring for DCS signs/symptoms. Venous gas emboli (VGE) and DCS outcomes were verified against NASA-STD-3001 acceptance criteria. RESULTS AND DISCUSSION: Venous gas emboli (VGE) were identified during all EVAs. A neurological DCS case was identified in the 90-min/29.6kPa prebreathe, terminating further testing of this protocol. No DCS cases were identified in the 150 min/29.6kPa protocol. The 20 min/36.5kPa protocol was rejected due to a Type II DCS case. All DCS symptoms resolved with treatment, with no sequelae post initial treatment of DCS. These various test points highlighted to the significant benefit of elevated suit pressure to shorten prebreathe protocols, but also the difficulty in assessing and managing DCS during sustained EVA operations in remote planetary surfaces.

decompression sickness↗
NASA NTRS1986

Evaluation of 9.5 PSIA as a suit pressure for prolonged extravehicular activity

A study was undertaken to determine if a pressure of 9.5 psia would aid against the occurrence of decompression sickness in both males and females (without prebreathing or stage decompression requirements) during a typical simulated extravehicular activity scenario. Twenty percent of the male subjects produced grades 1 and 2 bubbles while females did not produce bubble signals at all. It is concluded that a pressure of 9.5 psia can protect the astronaut from both formation of severe bubbling and development of bends symptoms when exposed to these study conditions.

Dixon, G. A.↗
NASA NTRS2003

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↗
NASA NTRS1993

Hypobaric decompression prebreathe requirements and breathing environment

To reduce incidence of decompression sickness (DCS), prebreathing 100 percent oxygen to denitrogenate is required prior to hypobaric decompressions from a sea level pressure breathing environment to pressures lower than 350 mm Hg (20,000 ft; 6.8 psia). The tissue ratio (TR) of such exposures equals or exceeds 1.7; TR being the tissue nitrogen pressure prior to decompression divided by the total pressure after decompression (((0.781)(14.697))/6.758). Designing pressure suits capable of greater pressure differentials, lower TR's, and procedures which limit the potential for DCS occurrence would enhance operational efficiency. The current 10.2 psia stage decompression prior to extravehicular activity (EVA) from the Shuttle in the 100 percent oxygen, 4.3 psia suit, results in a TR of 1.65 and has proven to be relatively free of DCS. Our recent study of zero-prebreathe decompressions to 6.8 psia breathing 100 percent oxygen (TR = 1.66) also resulted in no DCS (N = 10). The level of severe, Spencer Grades 3 or 4, venous gas emboli (VGE) increased from 0 percent at 9.5 psia to 40 percent at 6.8 psia yielding a Probit curve of VGE risk for the 51 male subjects who participated in these recent studies. Earlier, analogous decompressions using a 50 percent oxygen, 50 percent nitrogen breathing mixture resulted in one case of DCS and significantly higher levels of severe VGE, e.g., at 7.8 psia, the mixed gas breathing environment resulted in a 56 percent incidence of severe VGE versus 10 percent with use of 100 percent oxygen. The report of this study recommended use of 100 percent oxygen during zero-prebreathe exposure to 6.8 psia if such a suit could be developed. For future, long-term missions, we suggest study of the effects of decompression over several days to a breathing environment of 150 mmHg O2 and approximately 52 mmHg He as a means of eliminating DCS and VGE hazards during subsequent excursions. Once physiologically adapted to a 4 psia vehicle, base, or space station segment, crew members could use greatly simplified EVA suits with greater mobility and no prebreathe requirement.

Webb, James T.↗
NASA NTRS2006

Exploration Health Risks: Probabilistic Risk Assessment

Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of conservative and nonconservative assumptions on the probability results. We discuss the methods necessary to assess mission risks once exploration mission scenarios are characterized. Preliminary efforts have produced results that are commensurate with earlier qualitative estimates of risk probabilities in this and other operational contexts, indicating that our approach may be usefully applied in support of the development of human health and performance standards for long-duration space exploration missions. This approach will also enable mission-specific probabilistic risk assessments for space exploration missions.

Rhatigan, Jennifer↗
NASA NTRS2010

Statistical Challenges in Biomedical Research

Potentially debilitating effects of spaceflight environment include: a) Bone Demineralization - Osteoporosis. b)Impaired Fracture Healing - Non-Union. c) Renal Stone Formation & Soft Tissue Calcification. d) Orthostatic Intolerance (on return to gravity). e) Cardiac Arrhythmias. f) Dehydration (on return to gravity). g) Decreased Aerobic Capacity. h) Impaired Coordination. i) Muscle Atrophy (Loss of Strength). j) Radiation Sickness. k) Increased Cancer Risk. l) Impaired Immune Function. m) Behavioral Changes & Performance Decrements n) Altitude Decompression Sickness during EVA.

Feiveson, Alan H.↗
NASA NTRS1987

Empirical models for use in designing decompression procedures for space operations

Empirical models for predicting the incidence of Type 1 altitude decompression sickness (DCS) and venous gas emboli (VGE) during space extravehicular activity (EVA), and for use in designing safe denitrogenation decompression procedures are developed. The models are parameterized using DCS and VGE incidence data from NASA and USAF manned altitude chamber decompression tests using 607 male and female subject tests. These models, and procedures for their use, consist of: (1) an exponential relaxation model and procedure for computing tissue nitrogen partial pressure resulting from a specified prebreathing and stepped decompression sequence; (2) a formula for calculating Tissue Ratio (TR), a tissue decompression stress index; (3) linear and Hill equation models for predicting the total incidence of VGE and DCS attendant with a particular TR; (4) graphs of cumulative DCS and VGE incidence (risk) versus EVA exposure time at any specified TR; and (5) two equations for calculating the average delay period for the initial detection of VGE or indication of Type 1 DCS in a group after a specific denitrogenation decompression procedure. Several examples of realistic EVA preparations are provided.

Conkin, Johnny↗
NASA NTRS1996

Study of Hind Limb Tissue Gas Phase Formation in Response to Suspended Adynamia and Hypokinesia

The purpose of this study was to investigate the hypothesis that reduced joint/muscle activity (hypo kinesia) as well as reduced or null loading of limbs (adynamia) in gravity would result in reduced decompression-induced gas phase and symptoms of decompression sickness (DCS). Finding a correlation between the two phenomena would correspond to the proposed reduction in tissue gas phase formation in astronauts undergoing decompression during extravehicular activity (EVA) in microgravity. The observation may further explain the reported low incidence of DCS in space.

Butler, Bruce D.↗
NASA NTRS1997

Studies Relating to EVA

In this session, Session JA1, the discussion focuses on the following topics: The Staged Decompression to the Hypobaric Atmosphere as a Prophylactic Measure Against Decompression Sickness During Repetitive EVA; A New Preoxygenation Procedure for Extravehicular Activity (EVA); Metabolic Assessments During Extra-Vehicular Activity; Evaluation of Safety of Hypobaric Decompressions and EVA From Positions of Probabilistic Theory; Fatty Acid Composition of Plasma Lipids and Erythrocyte Membranes During Simulation of Extravehicular Activity; Biomedical Studies Relating to Decompression Stress with Simulated EVA, Overview; The Joint Angle and Muscle Signature (JAMS) System - Current Uses and Future Applications; and Experimental Investigation of Cooperative Human-Robotic Roles in an EVA Work Site.

Source record↗
NASA NTRS2007

Potential Fifty Percent Reduction in Saturation Diving Decompression Time Using a Combination of Intermittent Recompression and Exercise

Conventional saturation decompression protocols use linear decompression rates that become progressively slower at shallower depths, consistent with free gas phase control vs. dissolved gas elimination kinetics. If decompression is limited by control of free gas phase, linear decompression is an inefficient strategy. The NASA prebreathe reduction program demonstrated that exercise during O2 prebreathe resulted in a 50% reduction (2 h vs. 4 h) in the saturation decompression time from 14.7 to 4.3 psi and a significant reduction in decompression sickness (DCS: 0 vs. 23.7%). Combining exercise with intermittent recompression, which controls gas phase growth and eliminates supersaturation before exercising, may enable more efficient saturation decompression schedules. A tissue bubble dynamics model (TBDM) was used in conjunction with a NASA exercise prebreathe model (NEPM) that relates tissue inert gas exchange rate constants to exercise (ml O2/kg-min), to develop a schedule for decompression from helium saturation at 400 fsw. The models provide significant prediction (p < 0.001) and goodness of fit with 430 cases of DCS in 6437 laboratory dives for TBDM (p = 0.77) and with 22 cases of DCS in 159 altitude exposures for NEPM (p = 0.70). The models have also been used operationally in over 25,000 dives (TBDM) and 40 spacewalks (NEPM). The standard U.S. Navy (USN) linear saturation decompression schedule from saturation at 400 fsw required 114.5 h with a maximum Bubble Growth Index (BGI(sub max)) of 17.5. Decompression using intermittent recompression combined with two 10 min exercise periods (75% VO2 (sub peak)) per day required 54.25 h (BGI(sub max): 14.7). Combined intermittent recompression and exercise resulted in a theoretical 53% (2.5 day) reduction in decompression time and theoretically lower DCS risk compared to the standard USN decompression schedule. These results warrant future decompression trials to evaluate the efficacy of this approach.

Gernhardt, Michael I.↗
NASA NTRS1989

Human tolerance to space flight

Medical studies of astronauts and cosmonauts before, during, and after space missions have identified several effects of weightlessness and other factors that influence the ability of humans to tolerate space flight. Weightlessness effects include space motion sickness, cardiovascular abnormalities, reduction in immune system function, loss of red blood cells, loss of bone mass, and muscle atrophy. Extravehicular activity (EVA) increases the likelihood that decompression sickness may occur. Radiation also gives reason for concern about health of crewmembers, and psychological factors are important on long-term flights. Countermeasures that have been used include sensory preadaptation, prebreathing and use of various air mixtures for EVA, loading with water and electrolytes, exercise, use of pharmacological agents and special diets, and psychological support. It appears that humans can tolerate and recover satisfactorily from at least one year of space flight, but a number of conditions must be further ameliorated before long-duration missions can be considered routine.

Huntoon, C. L.↗
NASA NTRS2007

Environmental Physiology at the Johnson Space Center: Past, Present, and Future

This viewgraph presentation reviews the work in environmental physiology done at Johnson Space Center (JSC). The work is aimed at keeping astronauts healthy. This is a different approach than treating the sick, and is more of an occupational health model. The reduction of risks is the main emphasis for this work. They emphasis is to reduce the risk of decompression sickness (DCS) and acute mountain sickness (AMS). The work in environmental physiology encompasses the following areas: (1) Pressure: hypobaric and hyperbaric (2) Gases: hypoxia and hyperoxia, hypercapnia--closed space issues, inert gas physiology / respiration (3) Temperature: hypothermia and hyperthermia, thermal comfort, Protective clothing diving, aviation, mountaineering, and space (4) Acceleration (5) Noise and Vibration (6) Exercise / Performance (6) Acclimatization / Adaptation: engineering solutions when necessary. This presentation reviews the work done at JSC in the areas of DCS and AMS.

Conkin, Johnny↗
NASA NTRS1997

Dibutyryl cAMP effects on thromboxane and leukotriene production in decompression-induced lung injury

Decompression-induced venous bubble formation has been linked to increased neutrophil counts, endothelial cell injury, release of vasoactive eicosanoids, and increased vascular membrane permeability. These actions may account for inflammatory responses and edema formation. Increasing the intracellular cAMP has been shown to decrease eicosanoid production and edema formation in various models of lung injury. Reduction of decompression-induced inflammatory responses was evaluated in decompressed rats pretreated with saline (controls) or dibutyryl cAMP (DBcAMP, an analog of cAMP). After pretreatment, rats were exposed to either 616 kPa for 120 min or 683 kPa for 60 min. The observed increases in extravascular lung water ratios (pulmonary edema), bronchoalveolar lavage, and pleural protein in the saline control group (683 kPa) were not evident with DBcAMP treatment. DBcAMP pretreatment effects were also seen with the white blood cell counts and the percent of neutrophils in the bronchoalveolar lavage. Urinary levels of thromboxane B2, 11-dehydrothromboxane B2, and leukotriene E4 were significantly increased with the 683 kPa saline control decompression exposure. DBcAMP reduced the decompression-induced leukotriene E4 production in the urine. Plasma levels of thromboxane B2, 11-dehydrothromboxane B2, and leukotriene E4 were increased with the 683-kPa exposure groups. DBcAMP treatment did not affect these changes. The 11-dehydrothromboxane B2 and leukotriene E4 levels in the bronchoalveolar lavage were increased with the 683 kPa exposure and were reduced with the DBcAMP treatment. Our results indicate that DBcAMP has the capability to reduce eicosanoid production and limit membrane permeability and subsequent edema formation in rats experiencing decompression sickness.

Non-NASA Center↗
NASA NTRS1993

Project ARGO: Gas phase formation in simulated microgravity

The ARGO study investigated the reduced incidence of joint pain decompression sickness (DCS) encountered in microgravity as compared with an expected incidence of joint pain DCS experienced by test subjects in Earth-based laboratories (unit gravity) with similar protocols. Individuals who are decompressed from saturated conditions usually acquire joint pain DCS in the lower extremities. Our hypothesis is that the incidence of joint pain DCS can be limited by a significant reduction in the tissue gas micronuclei formed by stress-assisted nucleation. Reductions in dynamic and kinetic stresses in vivo are linked to hypokinetic and adynamic conditions of individuals in zero g. We employed the Doppler ultrasound bubble detection technique in simulated microgravity studies to determine quantitatively the degree of gas phase formation in the upper and lower extremities of test subjects during decompression. We found no evidence of right-to-left shunting through pulmonary vasculature. The volume of gas bubble following decompression was examined and compared with the number following saline contrast injection. From this, we predict a reduced incidence of DCS on orbit, although the incidence of predicted mild DCS still remains larger than that encountered on orbit.

Powell, Michael R.↗
NASA NTRS2016

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.↗