Sunday, January 23, 2011

Space Medicine Accelerating

One of NASA’s key initiatives is to adapt ultrasound to space flights and use ultrasound on the International Space Station (ISS) with remote guidance. The role for NASA’s Advanced Diagnostic Ultrasound in Microgravity (ADUM) research team, based at NASA’s Johnson Space Center, is to test how ultrasound is used in large medical centers and under laboratory conditions.

In studying the use of ultrasound for remote possibilities, the team links a remote expert with an on-site operator to conduct ultrasound examinations. The process is started when the ultrasound machine video output is transmitted to the remote expert via a satellite or internet connection with the on-site operator able to obtain the ultrasound images via voice commands.

The ADUM team has experience using ultrasound to help in remote environments such as on Mt. Everest and at the Arctic Circle. The team designed a self-contained system that includes a portable ultrasound device, solar power, satellite phone connectivity, and a laptop computer containing educational programs.

Using the technology enabled an untrained mountaineer to perform a complete lung ultrasound scan on a fellow climber on Mt. Everest using cue cards and remote guidance. When the non-expert did the ultrasound, he was able to send high quality ultrasound images to a remote expert to diagnose fluid in the lungs. A similar remote ultrasound system was used in the Canadian Arctic Circle enabling non-expert operators to perform targeted scans of almost every organ system.

The ADUM investigators are also studying how to use ultrasound to answer primary clinical diagnostic questions in unconventional settings where ultrasound is the only source of imaging, and where on-site expertise is limited.

In another project, by using NASA’s software developed at the Goddard Space Flight Center to enhance Earth science imagery, Bartron Medical Imaging was able to develop the new MED-SEG system to aid in the interpretation of mammograms, ultrasounds, and other medical imagery. The MED-SEG System can enable medical centers to send images via a secure internet connection to a Bartron data center for processing by the company’s imaging application. The data is then sent back to the medical center for use by medical personnel during diagnosis.

While crew health and performance depends on optimal brain function, many aspects of the spaceflight environment can adversely affect the brain and nervous system. Concerns include radiation, environmental toxins, elevated carbon dioxide levels, temperature extremes, nutritional effects, sleep deprivation, and chronic stress.

Physiological brain monitoring is not part of routine medical care for astronauts, due to an absence of practical neuromonitoring methods. The standard clinical brain imaging methods all fail to meet the basic flight requirements of low mass, low power, low volume, low crew time and low cost.

To address the ability to make in-flight neuromedical assessments, researchers at Harvard and Massachusetts General Hospital are in the process of developing lightweight, low power, mobile Near-Infrared Neuroimaging (NIN) systems that rely on near infrared light penetrating through several centimeters of tissue.

The technology underlying NIN can potentially support a range of field applications. The portable NINscan device is able to discriminate blood volume and oxygenation changes in the brain from those changes in the periphery, allowing examination of the effects of microgravity on blood circulation and tissue oxygenation. This is necessary to know to be able to diagnose and treat sleep deprivation, chronic stress, and depression.

On earth, numerous applications are possible since systems like NINscan could be used in outpatient settings to help identify neural markers of disease and to determine disease severity or treatment efficacy. Also, when caring for post-surgical brain-injured or sleep disordered patients, patients could wear devices such as NINscan to help with epilepsy or use if they are at risk for chronic subdural hematoma.

Another project nearing readiness for testing on the ISS is a device developed at the National Space Biomedical Research Institute. The device is a small noninvasive spectroscopic sensor that can continuously measure and report muscle metabolic parameters important in assessing the metabolic rate and the fitness and health of astronauts.

On earth, the spectroscopic sensor could be of value to emergency and critical care physicians in diagnosing and treating critically ill patients, plus the sensor holds promise for use in air, on ground ambulances, and on the battlefield. The device can also diagnose anemia and chronic heart problems. The muscle metabolic measurements may one day help rehabilitate patients with muscle injury or atrophy and be able to provide cost effective healthcare to adults and children in remote areas.

Two monitoring devices, Crew Physiological Observation Device (CPOD) and Biomedical Wireless and Ambulatory Telemetry for Crew Health (BioWATCH) are being developed to monitor the vital signs of astronauts aboard the ISS. Both devices would be worn on the body and would be able to wirelessly record or transmit information in real-time to a physician on Earth.

CPOD is being developed at Ames Research Center in partnership with Stanford University to track heart rates, blood pressure, body temperature, breathing rates, and blood oxygen content. With SBIR funding from The Glenn Research Center, ZIN Technologies has partnered with the Cleveland Clinic to develop BioWATCH to monitor heart rate, blood pressure, glucose, temperature, joint angels, body weight, planter pressure, electrocardiogram data, bold oxygenation, and other data.

ZIN Technology is also developing a commercial version of BioWATCH called vMetrics™, which has a platform technology that integrates with existing healthcare IT infrastructures supporting current patient electronic medical records standards. The device will transmit data in real-time via cell phone, wireless internet, or Bluetooth and has the capability to monitor patients receiving home care.

In addition, NIH along with other federal agencies, academic institutions, and industry are working together on the ISS to research projects of common interest. Specifically, NIH’s initial research on ISS will investigate specific disease processes in cells by using the microgravity environment to find novel mechanisms that scientists can use as targets for drug development.

A portion of the above information was abstracted from NASA’s magazine “Technology Innovation” in an issue devoted to health and medicine in both space and on Earth. To download the publication, and contacts, go to