Surgery in space: Where are we at now?

Drudi, Laura M.; Ball, Chad G.; Kirkpatrick, Andrew W.; Saary, Joan; Grenon, S. Marlene

doi:10.1016/j.actaastro.2012.04.014

Cited by 29 publications

(28 citation statements)

References 27 publications

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“…Ultrasound results may be affected by fluid shifts but remains a helpful diagnostic tool . Studies have shown there is no significant difference in observed blood loss during simulated laparoscopies …”

Section: Resultsmentioning

confidence: 99%

“…Blood collection in microgravity should be possible with the use of a vacuum, syringe, or pump. Infusion could be done with a pressure bag or a syringe …”

Section: Resultsmentioning

confidence: 99%

“…The possibility of evacuation will be largely dependent on distance from Earth and trajectory parameters. Even on the ISS in low Earth orbit, emergent evacuation could take more than 24 hours and cost over $100 million …”

Section: Resultsmentioning

confidence: 99%

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Blood transfusion for deep space exploration

et al. 2019

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BACKGROUND Astronauts on exploration missions may be at risk for traumatic injury and medical conditions that lead to life threatening hemorrhage. Resuscitation protocols are limited by the austere conditions of spaceflight. Solutions may be found in low‐resource terrestrial settings. The existing literature on alternative blood product administration and walking blood banks was evaluated for applicability to spaceflight. STUDY DESIGN AND METHODS A literature review was done using PubMed and Google Scholar. References were crosschecked for additional publications not identified using the initial search terms. Twenty‐seven articles were identified, including three controlled trials, six retrospective cohort analyses, 15 reviews, one case report, and two experimental studies. RESULTS Solutions to blood transfusion in austere settings include lyophilized blood products, hemoglobin‐based oxygen carriers (HBOCs), and fresh whole blood. Many of these products are investigational. Protocols for walking blood banks include methods for screening and activating donors, transfusion, and monitoring for adverse reactions. Microgravity and mission limitations create additional challenges for transfusion, including baseline physiologic changes, difficulty reconstituting lyophilized products, risk of air emboli during transfusion, equipment constraints, and limited evacuation and surgical options. CONCLUSION Medical planning for space exploration should consider the possibility of acute blood loss. A model for “floating” blood banks based on terrestrial walking blood bank protocols from austere environments is presented, with suggestions for future development. Constraints on volume, mass, storage, and crew, present challenges to blood transfusion in space and must be weighed against the benefits of expanding medical capabilities.

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Section: Resultsmentioning

confidence: 99%

“…Blood collection in microgravity should be possible with the use of a vacuum, syringe, or pump. Infusion could be done with a pressure bag or a syringe …”

Section: Resultsmentioning

confidence: 99%

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Blood transfusion for deep space exploration

et al. 2019

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“…Indeed, the heightened risk of contamination is potentially bidirectional, as conventional surgical barriers may not be effective without gravity. In addition, fluids and organs behave differently in space than on Earth, interfering with surgical exposure and retraction (5). Finally, microgravity may result in impaired postoperative wound healing (6,7).…”

Section: Unfavorable Physical Environmentmentioning

confidence: 99%

Space: The Final Frontier for IR

Kansagra

Shute

2015

Journal of Vascular and Interventional Radiology

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“…This proved to provide adequate drainage and eliminated the risk of contamination from the vehicle environment. Another advantage was that the blood from a hemothorax in this type of system could be used to autotransfuse a trauma victim [44].…”

Section: Spacecraft Emergenciesmentioning

confidence: 99%

Surgical Aspects of Space Medicine

Salem

2019

International Journal of Medical Arts

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Although the perception of surgery in space may appear obscure, it is vital to initiate planning early if new frontiers in space travel are to be accomplished. Conditions necessitating surgery in space are rare, but they are challenging in their management. Telemedicine can allow consultation and instruction at the time of surgical intervention. This may permit optimal guidance for conduction of simple surgical maneuvers by non-medical crew members. Robots could be used for more complex interventions in the absence of a trained crew member. Earth-tospace telesurgery is yet to be attained. However, National Aeronautics and Space Administration [NASA] has successfully did several basic procedures at an underwater facility, simulated the space environment. The communication delay between craft and earth is the main potential issue affecting telesurgery. For example a communication delay of radio signals between 4 and 22 minutes is expected between earth and Mars. Thus, available telesurgical capabilities are not suitable for a Mars mission. In addition, to facilitate endogenous repair of injured structures, the use of absorbable nanoparticulate scaffolds could offer temporary structure support, while eluting drugs stimulate endogenous mesenchymal stem cells to differentiate into osteoblasts. Otherwise, direct delivery of extrinsic mesenchymal stem cells to injured sites via nanoparticulate delivery system provide a reasonable alternative. The use of 3D printing allows fabrication of complex surgical tools from a computer-aided design template from a digital database of nearly each instrument. In addition, 3D-printed surgical tools may be disposable, meaning no requirement for space-occupying sterilization appliances.

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Surgery in space: Where are we at now?

Cited by 29 publications

References 27 publications

Blood transfusion for deep space exploration

Blood transfusion for deep space exploration

Space: The Final Frontier for IR

Surgical Aspects of Space Medicine

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