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Waligora, James M.

Publications and source records attributed to Waligora, James M..

Operational Implementation of a 2-Hour Prebreathe Protocol for International Space Station

Procedures, equipment, and analytical techniques were developed to implement the ground tested 2-hour protocol in-flight operations. The methods are: 1) The flight protocol incorporates additional safety margin over the ground tested protocol. This includes up to 20 min of additional time on enriched O2 during suit purge and pressure check, increased duration of extravehicular activity (EVA) preparation exercise during O2 prebreathing (up to 90 min vs; the tested 24 min), and reduced rates of depressurization. The ground test observations were combined with model projections of the conservative measures (using statistical models from Duke University and NASA JSQ to bound the risk of Type I and Type II decompression sickness (DCS). 2) An inflight exercise device using the in-flight ergometer and elastic tubes for upper body exercise was developed to replicate the dual cycle exercise in the ground trials. 3) A new in-flight breathing system was developed and man-tested. 4) A process to monitor inflight experience with the protocol, including the use of an in-suit Doppler bubble monitor when available, was developed. The results are: 1) The model projections of the conservative factors of the operational protocol were shown to reduce the risk of DCS to levels consistent with the observations of no DCS to date in the shuttle program. 2) Cross over trials of the dual cycle ergometer used in ground tests and the in-flight exercise system verified that02consumption and the % division of work between upper and lower body was not significantly different at the p= 0.05 level. 3) The in-flight breathing system was demonstrated to support work rates generating 75% O2(max) in 95 percentile subjects. 4) An in-flight monitoring plan with acceptance criteria was put in place for the 2-hour prebreathe protocol. And the conclusions are: The 2-hour protocol has been approved for flight, and all implementation efforts are in place to allow use of the protocol as early as flight ISS 7A, now scheduled in November of 2000.

Waligora, James M.↗

Project ARGO: Gas phase formation in simulated microgravity

The ARGO study investigated the reduced incidence of joint pain decompression sickness (DCS) encountered in microgravity as compared with an expected incidence of joint pain DCS experienced by test subjects in Earth-based laboratories (unit gravity) with similar protocols. Individuals who are decompressed from saturated conditions usually acquire joint pain DCS in the lower extremities. Our hypothesis is that the incidence of joint pain DCS can be limited by a significant reduction in the tissue gas micronuclei formed by stress-assisted nucleation. Reductions in dynamic and kinetic stresses in vivo are linked to hypokinetic and adynamic conditions of individuals in zero g. We employed the Doppler ultrasound bubble detection technique in simulated microgravity studies to determine quantitatively the degree of gas phase formation in the upper and lower extremities of test subjects during decompression. We found no evidence of right-to-left shunting through pulmonary vasculature. The volume of gas bubble following decompression was examined and compared with the number following saline contrast injection. From this, we predict a reduced incidence of DCS on orbit, although the incidence of predicted mild DCS still remains larger than that encountered on orbit.

Powell, Michael R.↗

Time to detection of circulating microbubbles as a risk factor for symptoms of altitude decompression sickness

This study investigated the association between time at onset of circulating microbubbles (CMB) and symptoms of altitude decompression sickness (DCS), using Cox proportional hazard regression models. The study population consisted of 125 individuals who participated in direct ascent, simulated extravehicular activities profiles. Using individual CMB status as a time-dependent variable, we found that the hazard for symptoms increased significantly (at the end of 180 min at altitude) in the presence of CMB (Hazard Ratio = 29.59; 95 percent confidence interval (95 percent CI) = 7.66-114.27), compared to no CMB. Further examination was conducted on the subgroup of individuals who developed microbubbles during the test (n = 49), by using Cox regression. Individuals with late onset of CMB (greater than 60 min at altitude) showed a significantly reduced risk of symptoms (hazard ratio = 0.92; 95 percent CI = 0.89-0.95), compared to those with early onset (equal to or less than 60 min), while controlling for other risk factors. We conclude that time to detection of circulating microbubbles is an independent determinant of symptoms of DCS.

Kumar, K. V.↗

The influence of prior exercise at anaerobic threshold on decompression sickness

This study was conducted to examine the effects of exercise prior to decompression on the incidence of altitude decompression sickness (DCS). In a balanced, two-period, crossover trial, 39 healthy individuals were each exposed twice, without denitrogenation, to an altitude of 6400 m in a hypobaric chamber. Under the experimental condition, subjects exercised at their predetermined anaerobic threshold levels for 30 min each day for 3 d prior to altitude exposure; the other condition was a non-exercise control. Under both conditions, subjects performed exercise simulating space extravehicular activities at altitude for a period of 3 h, while breathing 100 percent oxygen. There were nine preferences (untied responses) for DCS, four under control and five under experimental conditions; all were Type I, pain-only bends. No carry-over effects between exposures was detected, and the test for treatment differences showed p = 0.56 for symptoms. No significant difference in DCS preferences was found after subjects exercised up to their anaerobic threshold levels during the days prior to decompression.

Kumar, K. V.↗

Analysis of the individual risk of altitude decompression sickness under repeated exposures

In a case-control study, researchers examined the risk of decompression sickness (DCS) in individual subjects with higher number of exposures. Of the 126 subjects, 42 showed one or more episodes of DCS. Examination of the exposure-DCS relationship by odds ratio showed a linear relationship. Stratification analysis showed that sex, tissue ratio, and the presence of Doppler microbubbles were cofounders of this risk. A higher number of exposures increased the risk of DCS in this analysis.

Kumar, K. Vasantha↗

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 makes it possible 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 9144 m. Estimations using these regressions showed that, under a noprebreathe, 6-h exposure, simulated EVA profile, the threshold for symptoms occurred at approximately 3353 m; while under a noprebreathe, 2-h exposure profile with knee-bends exercise, the threshold occurred at 7925 m.

Kumar, K. V.↗

The effects of different rates of ascent on the incidence of altitude decompression sickness

The effect of different rates of ascent on the incidence of altitude decompression sickness (DCS) was analyzed by a retrospective study on 14,123 man-flights involving direct ascent up to 38,000 ft altitude. The data were classified on the basis of altitude attained, denitrogenation at ground level, duration of stay at altitude, rest or exercise while at altitude, frequency of exercise at altitude, and ascent rates. This database was further divided on the basis of ascent rates into different groups from 1000 ft/min up to 53,000 ft/min. The database was analyzed using multiple correlation and regression methods, and the results of the analysis reveal that ascent rates influence the incidence of DCS in combination with the various factors mentioned above. Rate of ascent was not a significant predictor of DCS and showed a low, but significant multiple correlation (R=0.31) with the above factors. Further, the effects of rates below 2500 ft/min are significantly different from that of rates above 2500 ft/min on the incidence of symptoms (P=0.03) and forced descent (P=0.01). At rates above 2500 ft/min and up to 53,000 ft/min, the effects of ascent rates are not significantly different (P greater than 0.05) in the population examined while the effects of rates below 2500 ft/min are not clear.

Kumar, K. V.↗

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-hr period prior to decompression to 4.3 psi. The subjects performed upper body exercises for 6 hr. Eight subjects were exposed to the same protocol after an 8-hr prebreathe. Venous bubbles were detected in 18 of 38 subjects decompressed after the 6-hr 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 hr. The incidence of symptoms and bubbles, when combined with prior data on 3.5- and 4.0-hr prebreathes, showed an inverse correlation to prebreathing time. The incidence of symptoms was higher than has been reported for subjects exposed to decompression of shorter duration with less activity.

Waligora, James M.↗

Empirical models for use in designing decompression procedures for space operations

Empirical models for predicting the incidence of Type 1 altitude decompression sickness (DCS) and venous gas emboli (VGE) during space extravehicular activity (EVA), and for use in designing safe denitrogenation decompression procedures are developed. The models are parameterized using DCS and VGE incidence data from NASA and USAF manned altitude chamber decompression tests using 607 male and female subject tests. These models, and procedures for their use, consist of: (1) an exponential relaxation model and procedure for computing tissue nitrogen partial pressure resulting from a specified prebreathing and stepped decompression sequence; (2) a formula for calculating Tissue Ratio (TR), a tissue decompression stress index; (3) linear and Hill equation models for predicting the total incidence of VGE and DCS attendant with a particular TR; (4) graphs of cumulative DCS and VGE incidence (risk) versus EVA exposure time at any specified TR; and (5) two equations for calculating the average delay period for the initial detection of VGE or indication of Type 1 DCS in a group after a specific denitrogenation decompression procedure. Several examples of realistic EVA preparations are provided.

Conkin, Johnny↗

The effect of exercise on venous gas emboli and decompression sickness in human subjects at 4.3 psia

The contribution of upper body exercise to altitude decompression sickness while at 4.3 psia after 3.5 or 4.0 hours of 100% oxygen prebreathing at 14.7 psia was determined by comparing the incidence and patterns of venous gas emboli (VGE), and the incidence of Type 1 decompression sickness (DCS) in 43 exercising male subjects and 9 less active male Doppler Technicians (DT's). Each subject exercised for 4 minutes at each of 3 exercise stations while at 4.3 psia. An additional 4 minutes were spent monitoring for VGE by the DT while the subject was supine on an examination cot. In the combined 3.5 and 4.0 hour oxygen prebreathe data, 13 subjects complained of Type 1 DCS compared to 9 complaints from DT's. VGE were detected in 28 subjects compared to 14 detections from DT's. A chi-square analysis of proportions showed no statistically significantly difference in the incidence of Type 1 DCS or VGE between the two groups; however, the average time to detect VGE and to report Tyep 1 DCS symptoms were statistically different. It was concluded that 4 to 6 hours of upper body exercise at metabolic rates simulating EVA metabolic rates hastens the initial detection of VGE and the time to report Type 1 DCS symptoms as compared to DT's.

Conkin, Johnny↗

Physiological and technological considerations for Mars mission extravehicular activity

The nature of the suit is a function of the needs of human physiology, the ambient environment outside the suit, and the type of activity to be accomplished while in the suit. The physiological requirements that must be provided for in the Martian Extravehicular Activity (EVA) suit will be reviewed. The influence of the Martian environment on the EVA suit and EVA capabilities is elaborated, and the Martian environment is compared with the lunar environment. The differences that may influence the EVA design are noted. The type, nature, and duration of activities to be done in transit to Mars and on the Martian surface will be evaluated and the impact of these activities on the requirements for EVA systems will be discussed. Furthermore, the interaction between Martian surface transportation systems and EVA systems will be covered. Finally, options other than EVA will be considered such as robotics, nonanthropometric suits, and vehicles with anthropometric extremities or robotic end effectors.

Waligora, James M.↗