Evaluating Trauma Sonography for Operational Use in the Microgravity Environment

Sonography is the only medical imaging modality aboard the ISS, and is likely to remain the leading imaging modality in future human space flight programs. While trauma sonography (TS) has been well recognized for terrestrial trauma settings, the technique had to be evaluated for suitability in space flight prior to adopting it as an operational capability. The authors found the following four-phased evaluative approach applicable to this task: 1) identifying standard or novel terrestrial techniques for potential use in space medicine; 2) developing and testing these techniques with suggested modifications on the ground (1g) either in clinical settings or in animal models, as appropriate; 3) evaluating and refining the techniques in parabolic flight (0g); and 4) validating and implementing for clinical use in space. In Phase I of the TS project, expert opinion and literature review suggested TS to be a potential screening tool for trauma in space. In Phase II, animal models were developed and tested in ground studies, and clinical studies were carried out in collaborating trauma centers. In Phase III, animal models were flight-tested in the NASA KC-135 Reduced Gravity Laboratory. Preliminary results of the first three phases demonstrated potential clinical utility of TS in microgravity. Phase IV studies have begun to address crew training issues, on-board imaging protocols, and data transfer procedures necessary to offer the modified TS technique for space use

Extraterrestrial Hemorrhage Control: Terrestrial Developments in Technique, Technology, and Philosophy with Applicability to Traumatic Hemorrhage in Space

Managing injury and illness during long duration space flight limits efforts to explore beyond low earths orbit. Traumatic injury may be expected to occur in space and is a frequent cause of preventable deaths, often related to uncontrolled or ongoing hemorrhage (H). Such bleeding causes 40% of terrestrial injury mortality. Current guidelines emphasize early control of H compared to intravenous infusions. Recent advances in surgical and critical care may be applicable to trauma care in space, with appropriate considerations of the extreme logistical and personnel limitations. Methods: Recent developments in technique, resuscitation fluids, hemoglobin (Hb) substitutes, hemostatic agents, interventional angiography, damage control principles, and concepts related to suspended animation were reviewed. Results: H associated with instability frequently requires definitive intervention. Direct pressure should be applied to all compressible bleeding, but novel approaches are required for intracavitary noncompressible bleeding. Intravenous hemostatic agents such as recombinant Factor VII may facilitate hemostasis especially when combined with a controlled hypotension approach. Both open and laparoscopic techniques could be used in weightlessness, but require technical expertise not likely to be available. Specific rehearsed invasive techniques such as laparotomy with packing, or arterial catherterization with with robotic intravascular embolization might be considered . Hemodynamic support, thermal manipulation, or pharmacologic induction of a state of metabolic down regulation for whole body preservation may be appropriate. Hypertonic saline, with or without dextran, may temporize vascular support and decrease reperfusion injury, with less mass than other solutions. Hb substitutes have other theoretical advantages. Conclusions: Terrestrial developments suggest potential novel strategies to control H in space, but will required a coordinated program of evaluation and training to evaluate

Severe traumatic injury during long duration spaceflight: Light years beyond ATLS

Traumatic injury strikes unexpectedly among the healthiest members of the human population, and has been an inevitable companion of exploration throughout history. In space flight beyond the Earth's orbit, NASA considers trauma to be the highest level of concern regarding the probable incidence versus impact on mission and health. Because of limited resources, medical care will have to focus on the conditions most likely to occur, as well as those with the most significant impact on the crew and mission. Although the relative risk of disabling injuries is significantly higher than traumatic deaths on earth, either issue would have catastrophic implications during space flight. As a result this review focuses on serious life-threatening injuries during space flight as determined by a NASA consensus conference attended by experts in all aspects of injury and space flight

O2‐06‐05: Toward understanding pathogenesis of ubqln2‐mediated ftd/als

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152677/1/alzjjalz201507163.pd

DLPC Liposomes Inhibit A beta Fibrillation and Remodel Preformed Fibrils Through a Detergent-like Mechanism

The aggregation of amyloid-b (Ab) on neuronal lipid bilayers is implicated in the neurotoxicity associated with Alzheimer???s disease. It is suggested that the aggregation on lipid bilayers is accelerated. This aggregation, in turn, is capable of disrupting bilayer integrity which induces cell death. We have found, however, that lipid bilayers composed of dilauroyl phosphatidylcholine (DLPC) undergo a unique mechanism of disruption. Through a combination of fluorescence measurements, microscopy, CD spectroscopy, and solid state NMR we have found that DLPC liposomes are rapidly disrupted through interactions with monomeric and early oligomeric forms of Ab. This disruption generates free lipid which successfully impedes amyloid formation through a detergent-like mechanism and stabilizes nontoxic, off pathway oligomers. DLPC liposomes are also capable of remodeling preformed fibrils of Ab into on-pathway, toxic protofibrillar species. All previous evidence of membrane disruption by Ab has been the result of fibrillation, pointing to a unique interaction occurring at the surface of DLPC membranes which is capable of halting amyloid formation in the early stages

Percutaneous bladder catheterization in microgravity

Ye

[P2–165]: Investigating The Role Of Ubiquilin2 In Age‐Related Neurodegeneration

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153058/1/alzjjalz201706816.pd

P3‐152: Investigating The Role Of Ubiquilin2 In Age‐Related Neurodegeneration

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153267/1/alzjjalz2018061510.pd

Ultrasound evaluation of the magnitude of pneumothorax: a new concept

Ye