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PubMedDate not supplied

[Medical studies during an 8-month flight on the orbital complex "Saliut-7"--"Soiuz-T"].

This paper presents medical results obtained in a Salyut-7 8-month manned mission in which a physician-cosmonaut took part. The results include body mass and height measurements, vestibular studies, cardiovascular studies at rest and in response to staged functional loads (with echocardiographic examinations accentuated), metabolic and hormonal studies. The paper also gives information about medical aspects of extravehicular activities. It is emphasized that during the mission both old and new methods of research were used and medical results of preceding flights were considered.

Adaptation, Physiological↗
PubMed1990

Threshold altitude resulting in decompression sickness.

A review of case reports, hypobaric chamber training data, and experimental evidence indicated that the threshold for incidence of Altitude Decompression Sickness (DCS) was influenced by various factors such as prior denitrogenation, exercise or rest and period of exposure, in addition to individual susceptibility. Fitting these data with appropriate statistical models has the potential for estimating the frequency of occurrence of DCS at various altitudes under different experimental conditions and allows us to examine the influence of various factors on the threshold for DCS. This approach was illustrated by logistic regression analysis on the incidence of DCS below 9,144 m (30,000 ft). Estimations using these regressions showed that under a noprebreathe, 6-h exposure, simulated extravehicular activity profile, the threshold for symptoms occurred at approximately 3,353 m (11,000 ft); while under a no-prebreathe, 2-h exposure profile with knee-bends exercise, the threshold occurred at 7,925 m (26,000 ft). These examples showed that definition of threshold altitude should be qualified by the particular combination of experimental variables under which it was observed.

Aerospace Medicine↗
PubMed1989

Human tolerance to 100% oxygen at 9.5 psia during five daily simulated 8-hour EVA exposures.

Extravehicular activity (EVA) currently involves decompression to 4.3 psia. This degree of decompression carries a significant potential for decompression sickness (DCS) which could be alleviated if a pressure of 9.5 psia could be maintained in the pressure suit. Previous studies have not evaluated the potential for oxygen toxicity at 9.5 psia. Twenty-one subjects were exposed to 100% oxygen at 9.5 psia for 5 consecutive days, 8 h.d-1 while performing moderate exercise to simulate a typical work-week in the proposed pressure suit environment. No DCS or venous gas bubbles were detected. Pulmonary function tests, physical exams, blood analyses, arterial oxygen saturation monitoring, and X-rays showed no evidence of oxygen toxicity under these conditions. These results suggest that a 100% oxygen, 9.5 psia pressure suit environment could avoid both DCS and oxygen toxicity during EVAs of comparable duration and physical activity.

Adult↗
PubMed1989

Blood biochemical and cellular changes during a decompression procedure involving eight hours of oxygen prebreathing.

Chemical and cellular parameters were measured in human subjects before and after exposure to a decompression schedule involving 8 h of oxygen prebreathing. The exposure was designed to simulate space-flight extravehicular activity (EVA) for 6 h. Several statistically significant changes in blood parameters were observed following the exposure: increases in calcium, magnesium, osmolality, low-density lipoprotein cholesterol, monocytes, and prothrombin time, and decreases in chloride, creatine phosphokinase and eosinophils. The changes, however, were small in magnitude and blood factor levels remained within normal clinical ranges. Thus, the decompression profile used in this study is not likely to result in blood changes that would pose a threat to astronauts during EVA.

Blood Cells↗
PubMed1987

The effect of extended O2 prebreathing on altitude decompression sickness and venous gas bubbles.

The purpose of this study was to determine the effect of extended O2 prebreathing on symptom and bubble incidence during decompressions simulating extravehicular activity. The 38 subjects breathed O2 for a 6-h period prior to decompression to 4.3 psi. The subjects performed upper body exercise for 6 h. Subjects were monitored with a Doppler bubble detector and were encouraged to report all symptoms. Eight subjects were exposed to the same protocol after an 8-h prebreathe. Venous bubbles were detected in 18 of 38 subjects decompressed after the 6-h prebreathe. Four of these subjects reported symptoms of altitude decompression sickness. No symptoms or bubbles were detected in the eight subjects who had prebreathed 8 h. The incidence of symptoms and bubbles when combined with prior data on 3.5- and 4.0-hour prebreathes showed an inverse correlation to pre-breathing time. The incidence of symptoms was higher than has been reported for subjects exposed to decompression of shorter duration with less activity.

Adult↗
PubMed1988

Decompression sickness and bubble formation in females exposed to a simulated 7.8 psia suit environment.

The purpose of this study was to measure female susceptibility to decompression sickness (DCS) during simulated extravehicular activity (EVA) at a candidate (7.8 psia) suit pressure. Thirty female volunteer subjects, in groups of three, were exposed to three consecutive daily EVA simulations at 7.8 psia (5,031 m altitude equivalent) continuously for 6 h. During each altitude exposure, the subjects breathed a gas mixture of 50% oxygen/50% nitrogen, and participated in exercise workloads similar to those expected to be experienced by astronauts during a typical EVA scenario. Precordial Doppler bubble monitoring was accomplished after each cycle of exercise workload simulations. During at least 1 of the 3 days (d) of exposure, 43% of the subjects experienced intravenous bubbling. Of the 30 subjects, 17 (57%) did not experience detectable bubbling on any of the 3 d of exposure and 5 (17%) developed decompression sickness (DCS) during the study. Two cases were delayed, occurring after recompression to ground level; and three subjects required hyperbaric oxygen treatment. The results of this study suggest that female subjects may suffer more delayed DCS symptoms, necessitating hyperbaric oxygen treatment, than their male counterparts under the same experimental conditions. Female subjects did not experience intravenous bubbling as frequently as male subjects when exposed to these study conditions.

Adult↗
PubMedDate not supplied

[Relation between the probability of development of altitude-decompression disorders and the duration of pre-exposure to a hypobaric atmosphere].

Healthy volunteers, aged 21-47 years, were kept in an altitude chamber. Before decompression to a residual pressure of 293.3 GPa the test subjects were consecutively exposed to 1120 GPa for 2 hrs and then to 733.3 GPa for 24, 18 or 12 hrs. At 293.3 GPa the test subjects performed a moderate workload for 6 hrs. It has been concluded that prior to the use of a space suit with the working pressure 0.3 kgf/cm2 (293.3 GPa) the time of exposure to a hypobaric normoxic (29-30% O2) atmosphere with the total barometric pressure 733.3 GPa should not be less than 18 hrs and it should preferably be 24 hrs. In this situation decompression safety of 6-hr extravehicular activity can be predicted with a high probability.

Adaptation, Physiological↗
PubMed1987

Effects of microgravity on tissue perfusion and the efficacy of astronaut denitrogenation for EVA.

The prevention of astronaut decompression sickness (DCS) during extravehicular activity (EVA) from the Shuttle Orbiter entails basic questions about how the efficacies of pre-EVA denitrogenations are affected by physiological responses and adaptations to microgravity. Many of these questions may be answered, without requiring inflight decompression experiments, when suitable inflight measurements of N2 elimination from spacecrew breathing 100% O2 can be analyzed using an N2 elimination/DCS risk correlation which has been calibrated in ground-based studies. In order to pursue this approach in our laboratory, a potentially flight-applicable, breath-by-breath method for measuring N2 elimination from human subjects breathing 100% O2 for 2-3-h periods has been developed. The present report describes this development with particular emphasis on required methodological accuracy and its achievement in view of certain properties of mass spectrometer performance. A method for the breath-by-breath analysis of errors in measured N2 elimination profiles is also described.

Adaptation, Physiological↗
PubMed1987

Probability of oxygen toxicity using an 8 psi space suit.

Breathing oxygen at high partial pressure is toxic to all systems of the body. However, the effect a of a high PO2 on the pulmonary and erythropoietic systems pose the greatest threat to the EVA astronaut utilizing a single gas space suit system. Oxygen toxicity has been studied extensively, and a review of the literature suggests that continuous exposure to a PO2 of 8 psi can be tolerated indefinitely and should not present the astronaut with a problem for the Extravehicular Activity (EVA) scenarios projected for Space Station. However, the cause of the decrease in circulating red blood cell mass, which has been shown to accompany exposure to microgravity as well as hyperoxemia, is not as well defined when both conditions are simultaneously present.

Decompression↗
PubMed1986

Decompression sickness and intravenous bubble formation using a 7.8 psia simulated pressure-suit environment.

The purpose of this study was to determine the minimum spacesuit pressure required to prevent decompression sickness (DCS) during operational conditions in a 50% oxygen/50% nitrogen environment. In this study, 30 male volunteer subjects were exposed in groups of three, to three consecutive daily extravehicular activity (EVA) simulations at 7.8 psia (5,031 m altitude equivalent) for a continuous period of 6 h. During each altitude exposure, the subjects participated in similar exercise workloads expected to be experienced by astronauts during a typical EVA scenario. Precordial Doppler monitoring revealed that 73.3% of the subjects had intravenous bubbling during at least 1 d of the 3 d of exposure, with 26.7% remaining bubble-free during the entire study. No correlation was found between either body fat or age and incidence of bubble formation. One case of DCS occurred during the study indicating that 7.8 psia is not sufficient pressure to totally preclude DCS in a 50% oxygen/50% nitrogen environment. The necessary pressure awaits further study.

Adult↗
PubMed1994

Cellular immunity in cosmonauts during long duration spaceflight on board the orbital MIR station.

To investigate the effect of spaceflight on cell mediated immunity we tested delayed-type hypersensitivity (DTH) in 5 cosmonauts on three missions in the orbital space station MIR. DTH was determined by the intradermal application of seven antigens and a control using the standardized Multitest Mérieux. This multiple prick puncture test was applied prior to, during, and following missions, which lasted for up to 177 d. In four of the five cosmonauts, reaction scores of DTH-responses below the warning level were noted during flight (two subjects) or following landing (two subjects). In-flight reductions of DTH-responses were possibly induced by a series of stressful extravehicular activities and recovered to normal levels after landing. The results confirm earlier observations of a decreased lymphocyte function following spaceflights determined by means of mitogenic responsiveness of lymphocytes. Thus, the notion of a possibly impaired cell-mediated immunity under stress in association with spaceflight gains further support.

Humans↗
PubMed1993

Breathing 100% oxygen compared with 50% oxygen: 50% nitrogen reduces altitude-induced venous gas emboli.

The risk of venous gas emboli (VGE) and decompression sickness (DCS) must be determined before selection of the lowest pressure for an extravehicular activity (EVA) pressure suit which eliminates the requirement for prebreathing. In earlier studies, use of a 50% oxygen:50% nitrogen breathing mixture (50:50 mix) during 139 zero-prebreathe decompressions of male subjects to 8.3-7.8 psia resulted in 51 instances of severe VGE and one case of DCS. Our current study investigated effects of 40 zero-prebreathe decompressions of male subjects to 8.3-6.8 psia for 6 h while breathing 100% oxygen and performing moderate exercise. No DCS symptoms were observed. Severe VGE were not detected at 8.3 psia, but were present during 10%, 20%, and 40% of the exposures at 7.8, 7.3, and 6.8 psia, respectively. Zero-prebreathe decompression while breathing 100% oxygen results in significantly lower VGE and DCS risk levels than while breathing a 50:50 mix. Our results show that 7.3 psia EVA pressure suits with 100% oxygen should be safer than 8.3 psia suits with a 50:50 mix.

Aerospace Medicine↗
PubMedDate not supplied

[Structural and functional disorders of erythrocyte membranes in simulated extravehicle space work].

The experimental data on a structural-and-functional status of erythrocyte membranes in ground-based simulation of human extravehicular activity (EVA) are discussed. The changes in the structure and function of erythrocyte membrane were determined from the fixation of lipophilic ions, specific activity of ion-transporting adenosine triphosphatases and content of the products of peroxide oxidation of lipids (POL) in plasma. On exposure to hypobaric hyperoxia during real EVA the membrane status changes are associated with the activation of a cascade of POL processes.

Adenosine Triphosphatases↗
PubMed1993

Rationale for a hyperbaric treatment capability at a Lunar Station.

Missions to establish a permanent presence on the Moon will include a significant amount of extravehicular activity (EVA), which carries the risk of decompression sickness (DCS). Factors which will influence that risk include: cabin and space suit pressure environments, frequency of an activity level during EVA, and the possibility of a loss-of-pressure mishap. These factors were considered for Space Station Freedom (SSF), resulting in the decision to include a hyperbaric airlock capable of treating DCS. Using concepts from operational medicine, the need for such a capability is determined by its influence on mission risk. In comparison to SSF, a Lunar Station will have gravity, a higher EVA rate, physically more DCS provocative EVA, and little, if any, capacity for medical evacuation. Therefore, unless Lunar mission planners can provide pressure environments that offer near zero risk of DCS for nominal operations, a hyperbaric treatment capability should be included.

Aerospace Medicine↗
PubMed1996

Exercise-enhanced preoxygenation increases protection from decompression sickness.

INTRODUCTION: Prevention of decompression sickness (DCS) during exposure to altitude equivalents of 30,000 ft (9144 m) requires extensive denitrogenation. In preparation for extravehicular activity (EVA), present NASA policy is to denitrogenate using a 10.2 psia staged decompression of the entire shuttle for at least 12 h, including 100 min of preoxygenation (breathing 100% oxygen at 14.7 psia prior to decompression), before decompression to the 4.3 psia (30,000 ft; 9144 m) suit pressure. This staged decompression provides the same or better protection from DCS as a 3.5- or 4-h preoxygenation used on earlier Shuttle EVA's. For high altitude reconnaissance flights at similar cockpit altitudes, a 1-h preoxygenation is currently required. METHODS: We have investigated the use of a 1-h and a 15-min preoxygenation period, each beginning with 10 min of dual-cycle ergometry performed at 75% of each subject's peak oxygen consumption (VO2peak) to enhance preoxygenation efficiency by increasing perfusion and ventilation. Male subjects accomplished a 1-h preoxygenation with exercise, a 15-min preoxygenation with exercise, or a 1-h resting preoxygenation before exposure to 4.3 psia for 4 h while performing light to moderate exercise. RESULTS: Incidence of DCS following the 1-h preoxygenation with exercise (42%; n = 26) was significantly less than that following the 1-h resting preoxygenation (77%; n = 26). Incidence and onset of DCS following the 15-min preoxygenation with exercise (64%; n = 22) was not significantly different from the incidence following the 1-h resting control. CONCLUSION: Preoxygenation with exercise has been shown to provide significantly improved DCS protection when compared with resting preoxygenation.

Adult↗
PubMed1996

Cardiovascular deconditioning and venous air embolism in simulated microgravity in the rat.

BACKGROUND: Astronauts conducting extravehicular activities undergo decompression to a lower ambient pressure, potentially resulting in gas bubble formation within the tissues and venous circulation. Additionally, exposure to microgravity produces fluid shifts within the body leading to cardiovascular deconditioning. A lower incidence of decompression illness in actual spaceflight compared with that in ground-based altitude chamber flights suggests that there is a possible interaction between microgravity exposure and decompression illness. HYPOTHESIS: The purpose of this study was to evaluate the cardiovascular and pulmonary effects of simulated hypobaric decompression stress using a tail suspension (head-down tilt) model of microgravity to produce the fluid shifts associated with weightlessness in conscious, chronically instrumented rats. METHODS: Venous bubble formation resulting from altitude decompression illness was simulated by a 3-h intravenous air infusion. Cardiovascular deconditioning was simulated by 96 h of head-down tilt. Heart rate, mean arterial blood pressure, central venous pressure, left ventricular wall thickening and cardiac output were continuously recorded. Lung studies were performed to evaluate edema formation and compliance measurement. Blood and pleural fluid were examined for changes in white cell counts and protein concentration. RESULTS: Our data demonstrated that in tail-suspended rats subjected to venous air infusions, there was a reduction in pulmonary edema formation and less of a decrease in cardiac output than occurred following venous air infusion alone. Mean arterial blood pressure and myocardial wall thickening fractions were unchanged with either tail-suspension or venous air infusion. Heart rate decreased in both conditions while systemic vascular resistance increased. CONCLUSIONS: These differences may be due in part to a change or redistribution of pulmonary blood flow or to a diminished cellular response to the microvascular insult of the venous air embolization.

Animals↗
PubMed1998

Towards new paradigms for the treatment of hypobaric decompression sickness.

Altitude induced (hypobaric) decompression sickness (DCS) has long been treated with ground level oxygen and U.S. Navy Treatment Tables 5 and 6. These treatment tables originate from surface excursion diving and, when implemented, require significant resource allocation. Although they are effective treatment regimens, these tables were not developed for treating hypobaric DCS which has an etiology similar to saturation diving DCS. In this review, different treatment options for hypobaric DCS are presented. These options include more aggressive use of ground level oxygen and treatment tables using a maximum pressure of 2 atmospheres (ATA). Specific attention is given to USAF Table VIII, an experimental hypobaric DCS treatment-table, and space suit overpressurization treatment. This paradigm shift for DCS treatment is based on a projected increase in hypobaric DCS treatment from exposure to low pressure during several operational conditions: cruise flight in the next generation aircraft (e.g., F-22); high altitude, unpressurized flight by special operations forces; and the extraordinary amount of extravehicular activity (EVA) required to construct the international space station. Anticipating the need to treat DCS encountered during these and other activities, it is proposed that 2 ATA or less hyperbaric oxygen (HBO) treatment conjoined with new collapsible chamber technology can be used to address these issues in a safe and cost effective fashion.

Aerospace Medicine↗
PubMed1998

Plasma volume expansion with oral fluids in hypohydrated men at rest and during exercise.

BACKGROUND: The purpose for this study was to evaluate various carbohydrate (CHO)-electrolyte fluid formulations for consumption by astronauts to maintain or restore their plasma volume (PV) and total body water (TBW) during and after extravehicular activity (exercise experiment, EE) and for a few hours before reentry and immediately after landing (rest experiment RE). HYPOTHESIS: That fluid formulation electrolyte content would be more important than osmotic (Osm) content for increasing or maintaining PV during the RE and EE. METHODS: In the RE, 5 healthy men (23-44 yr), previously dehydrated for 24 h, drank 6 fluid formulations (Water, 19.6 Na, 157 Na, 19.6 Na + glucose, and the prepared drinks Performances and Power)--one each at weekly intervals, and then sat for 70 min. In the EE, four healthy 24-h dehydrated men (30-46 yr) exercised for 70 min supine on a cycle ergometer (load = 71 +/- 1% peak VO2). RESULTS: Rest: Subjects who consumed formulations with total Osm concentrations nearer the normal range (157 Na - 270 mOsm x kg(-1), Performance with 19.6 mEq x L(-1) Na - 380 mOsm, and to some extent Power with 23.5 mEq x L(-1) Na - 390 mOsm) had the greater increases in PV; intake of drink 157 Na, with the largest Na content, induced the greatest hypervolemia of 7.6% (p < 0.05). The various additional ions, in addition to 19.6 Na, probably contributed to the 4.6% (p < 0.05) hypervolemia with Performance. Water was not effective. Exercise: Stabilization of PV between 15-70 min was not related to drink total CHO, Na or Osm content. Performance and 157 Na were no more effective than 19.6 Na or 19.6 Na + glu for PV stabilization. Water was the least effective. Regulatory mechanisms controlling PV during exercise appear to be independent of oral fluid formulation Osm-electrolyte content. CONCLUSIONS: Drink cation (sodium) content is more important that its total osmotic content for increasing plasma volume at rest. Fluid formulations with greater hypervolemic action in resting subjects may not be as effective during exercise; therefore different formulations for use during exercise appear to be necessary.

Adult↗