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Overview

Minimally Invasive Diagnosis and Therapy of Microgravity Medical Contingencies

Principal Investigator:
Scott A. Dulchavsky, M.D., Ph.D.

Organization:
Henry Ford Health System

A number of crew health situations, such as severe abdominal pain, dental or sinus infection, musculo-skeletal injury, and eye trauma, could severely impact the success of long-duration space missions. Diagnosing and managing acute health problems on these flights is problematic due to several factors, including lack of information on how microgravity impacts anatomy, disease presentation, and therapy effectiveness. Dr. Scott Dulchavsky is studying the ability to use miniature laparoscopy, in combination with ultrasound, in patient studies involving select health situations which would have a high impact on mission success. These diagnostic tools will then be evaluated in animal models under simulated microgravity situations. His team will use this information to optimize training regimens and refresher modules for non-physician crew medical officers to diagnose and treat astronaut medical conditions during long-duration space flight. The diagnostic, treatment, and training protocols which will be developed in this study will also provide information which can be used in rural care, military conflicts, and third world medicine on Earth.

NASA Taskbook Entry

Technical Summary

The diagnosis and management of acute health problems in space is problematic due to limited training of the Crew Medical Officer (CMO), human and environmental factors, and a lack of reference of the changes in anatomy, disease presentation and therapy in microgravity. There is no planned radiological capability aboard the International Space Station further complicating medical diagnosis in space. Recent terrestrial investigations suggest expanded clinical applications of ultrasound and laparoscopy with miniature instrumentation, both of which have applicability for aerospace medicine. This project will determine the diagnostic utility of ultrasound and/or micro-laparoscopy in select health contingencies with high mission impact potential. These diagnostic modalities will then be used to facilitate minimally invasive, definitive surgical therapy of selected contingencies in animal models in ground-based and simulated microgravity scenarios. Optimal just-in-time training regimens and computer-based refresher modules for non-physician CMOs to accomplish these tasks will be developed.

The unique constraints imposed by training, equipment limitations and the space environment require the development of novel diagnostic and therapeutic strategies for crew member health problems including the expansion of ultrasound and mini-laparoscopy. Thoracic ultrasound, initially investigated by NASA as an alternative diagnostic modality for pneumothorax, has proven accuracy in terrestrial and microgravity applications and will have widespread impact in acute care on Earth in the future. Although some of the techniques investigated in this project are appropriate only for a microgravity environment, the majority of the diagnostic and therapeutic algorithms are readily transferable to terrestrial medicine including rural and military applications. The expanded use of the diagnostic and training modalities described in this project, if verified, would provide a significant, clinically-relevant advance in space medical capabilities with profound Earth-based ramifications.

Earth Applications

The just-in-time training algorithms developed in this project can be used to rapidly train non-medical personnel to perform complex medical diagnosis and treatment. These could be used in rural, military or third-world countries to deliver high-quality medical care. We have recently collaborated with a company, MEDIPHAN, which has video-streaming technology to make ground-based applications seamless. We will work in partnership to establish activities for sporting, military and emergency applications.
This project's funding ended in 2007