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At least 37 records · Page 2
All sourcesNASA NTRSDOE OSTI
NASA NTRS1987

Decompression sickness and venous gas emboli at 8.3 psia

This study sought to determine the bends risk on decompression from sea level to 8.3 psia. On the basis of several prior studies by NASA and the Air Force, this differential was expected to result in a minimal (about 5 percent) incidence of mild decompression sickness, and may be the pressure of choice for the next-generation NASA extravehicular activity (EVA) pressure suit. Thirty-one volunteer subjects, performing light work characteristic of EVA, were exposed to 8.3 psia pressure altitude for six hours. Limb bends incidence was 3.2 percent, and 25.8 percent of the subjects demonstrated significant intravascular bubbling. Those who bubbled were significantly older than the bubble-free group, but differed in no other aspect. An 8.3 psia advanced pressure suit design was considered insufficient to totally preclude the risk of decompression sickness.

Smead, Kenneth W.↗
NASA NTRS1974

Decompression sickness in simulated Apollo-Soyuz space missions

Apollo-Soyuz docking module atmospheres were evaluated for incidence of decompression sickness in men simulating passage from the Russian spacecraft atmosphere, to the U.S. spacecraft atmosphere, and then to the American space suit pressure. Following 8 hr of 'shirtsleeve' exposure to 31:69::O2:N2 gas breathing mixture, at 10 psia, subjects were 'denitrogenated' for either 30 or 60 min with 100% O2 prior to decompression directly to 3.7 psia suit equivalent while performing exercise at fixed intervals. Five of 21 subjects experienced symptoms of decompression sickness after 60 min of denitrogenation compared to 6 among 20 subjects after 30 min of denitrogenation. A condition of Grade I bends was reported after 60 min of denitrogenation, and 3 of these 5 subjects noted the disappearance of all symptoms of bends at 3.7 psia. After 30 min of denitrogenation, 2 out of 6 subjects developed Grade II bends at 3.7 psia.

Cooke, J. P.↗
NASA NTRS1980

Hazards of high altitude decompression sickness during falls in barometric pressure from 1 atm to a fraction thereof

Various tests related to studies concerning the effects of decompression sicknesses at varying pressure levels and physical activity are described. The tests indicate that there are no guarantees of freedom from decompression sicknesses when man transitions from a normally oxygenated normobaric nitrogen-oxygen atmosphere into an environment having a 0.4 atm or lower pressure and he is performing physical work.

Genin, A. M.↗
NASA NTRS2007

Spaceflight Decompression Sickness Contingency Plan

A viewgraph presentation on the Decompression Sickness (DCS) Contingency Plan for manned spaceflight is shown. The topics include: 1) Approach; 2) DCS Contingency Plan Overview; 3) Extravehicular Activity (EVA) Cuff Classifications; 4) On-orbit Treatment Philosophy; 5) Long Form Malfunction Procedure (MAL); 6) Medical Checklist; 7) Flight Rules; 8) Crew Training; 9) Flight Surgeon / Biomedical Engineer (BME) Training; and 10) DCS Emergency Landing Site.

Dervay, Joseph P.↗
NASA NTRS2024

Updates to NASA’S Break-in-Prebreathe Flight Rules Due to Type II Decompression Sickness Risk Considerations

Investigation of a central neurological decompression sickness (DCS) case during hypobaric ground testing at Johnson Space Center (JSC) identified a ~3 min break-in-prebreathe (BiP) late in the prebreathe (13 min prior to depressurization) as the leading credible cause for the DCS case. This occurred despite applicable prebreathe payback rules being followed. Applicable NASA rules, for ground and flight, directed 2:1 payback of breaks up to 10 min in duration, regardless of when a break occurs relative to depress. Breaks lasting longer than 10 min require a complete restart of the prebreathe protocol. The adequacy of NASA’s BiP rules was evaluated prior to resuming any hypobaric ground testing or International Space Station (ISS) extravehicular activity (EVA). Of particular interest to the authors was the timing of the BiP in relation to the overall prebreathe timeline. Although there exists no agreed-upon definition, a ‘late’ BiP means towards the end of the prebreathe period, and in particular, the last hour prior to depressurization. The following information sources were reviewed prior to formulating recommendations: i) the type II DCS case report and findings from the investigation; ii) documented rationale for existing flight rules, iii) consultations with subject matter experts involved in definition of existing flight rules (several of whom had since left NASA); iv) relevant published literature; v) tissue gas loading model estimates; and vi) NASA’s operational experience with late breaks in prebreathe.

Andrew F J Abercromby↗
NASA NTRS1993

Risk of decompression sickness in the presence of circulating microbubbles

In this study, we examined the association between microbubbles formed in the circulation from a free gas phase and symptoms of altitude decompression sickness (DCS). In a subgroup of 59 males of mean (S.D) age 31.2 (5.8) years who developed microbubbles during exposure to 26.59 kPa (4.3 psi) under simulated extravehicular activities (EVA), symptoms of DCS occurred in 24 (41 percent) individuals. Spencer grade 1 microbubbles occurred in 4 (7 percent), grade 2 in 9 (15 percent), grade 3 in 15 (25 percent), and grade 4 in 31 (53 percent) of subjects. Survival analysis using Cox proportional hazards regression showed that individuals with less than grade 3 CMB showed 2.46 times (95 percent confidence interval = 1.26 to 5.34) higher risk of symptoms. This information is crucial for defining the risk of DCS for inflight Doppler monitoring under space EVA. Altitude decompression sickness (DCS) occurs when there is acute reduction in ambient pressure. The symptoms of DCS are due to the formation of a free gas phase (in the form of gas microbubbles) in tissues during decompression. Musculo-skeletal pain of bends is the commonest form of DCS in altitude exposures. In the space flight environment, there is a risk of DCS when astronauts decompress from the normobaric shuttle pressure into the hypobaric space suit pressure (currently about 29.65 kPa (4.3 psi) for extra-vehicular activities (EVA). This risk is counterbalanced by a judicious combination of prior denitrogenation and staged decompression. Studies of DCS are limited by the duration of the test at reduced pressure. Since only a proportion of subjects tested develop symptoms, the information on DCS is generally incomplete or 'censored'. Many studies employ Doppler ultrasound monitoring of the precordial area for detecting circulating microbubbles (CMB). Although the association between CMB and bends pain is not causal, CMB are frequently monitored during decompression. In this paper, we examine the association between CMB and symptoms of DCS under simulated EVA profiles.

Kumar, K. Vasantha↗
NASA NTRS1972

Predictive modeling of altitude decompression sickness in humans

The coding of data on 2,565 individual human altitude chamber tests is reported as part of a selection procedure designed to eliminate individuals who are highly susceptible to decompression sickness, individual aircrew members were exposed to the pressure equivalent of 37,000 feet and observed for one hour. Many entries refer to subjects who have been tested two or three times. This data contains a substantial body of statistical information important to the understanding of the mechanisms of altitude decompression sickness and for the computation of improved high altitude operating procedures. Appropriate computer formats and encoding procedures were developed and all 2,565 entries have been converted to these formats and stored on magnetic tape. A gas loading file was produced.

Kenyon, D. J.↗
NASA NTRS1994

The effectiveness of ground level post-flight 100 percent oxygen breathing as therapy for pain-only altitude Decompression Sickness (DCS)

In both the aviation and space environments, decompression sickness (DCS) is an operational limitation. Hyperbaric recompression is the most efficacious treatment for altitude DCS. However, the inherent recompression of descent to ground level while breathing oxygen is in itself therapy for altitude DCS. If pain-only DCS occurs during a hypobaric exposure, and the symptoms resolver during descent, ground level post-flight breathing of 100% O2 for 2 hours (GLO2) is considered sufficient treatment by USAF Regulation 161-21. The effectiveness of the GLO2 treatment protocol is defined.

Demboski, John T.↗
NASA NTRS1999

An Evidenced-Based Approach for Estimating Decompression Sickness Risk in Aircraft Operations

Estimating the risk of decompression Sickness (DCS) in aircraft operations remains a challenge, making the reduction of this risk through the development of operationally acceptable denitrogenation schedules difficult. In addition, the medical recommendations which are promulgated are often not supported by rigorous evaluation of the available data, but are instead arrived at by negotiation with the aircraft operations community, are adapted from other similar aircraft operations, or are based upon the opinion of the local medical community. We present a systematic approach for defining DCS risk in aircraft operations by analyzing the data available for a specific aircraft, flight profile, and aviator population. Once the risk of DCS in a particular aircraft operation is known, appropriate steps can be taken to reduce this risk to a level acceptable to the applicable aviation community. Using this technique will allow any aviation medical community to arrive at the best estimate of DCS risk for its specific mission and aviator population and will allow systematic reevaluation of the decisions regarding DCS risk reduction when additional data are available.

Robinson, Ronald R.↗
NASA NTRS2024

Updates to NASA’s Break-in-Prebreathe Rules Due to Type II Decompression Sickness Risk Considerations

INTRODUCTION. Investigation of a central neurological decompression sickness (DCS) case during ground testing at Johnson Space Center identified a break-in-prebreathe (BIP) 13 minutes prior to depressurization as the leading credible cause despite applicable prebreathe payback rules being followed. Applicable NASA rules, for ground and flight, directed 2:1 payback of breaks up to 10 mins in duration, regardless of when a break occurs relative to depress. Full restart of prebreathe is directed following breaks > 10 min. The adequacy of NASA’s BIP rules was evaluated prior to resuming hypobaric ground testing or ISS extravehicular activities. METHODS. The following information sources were reviewed prior to formulating recommendations: i) Type II DCS case report and investigation findings; ii) documented rationale for existing flight rules, iii) consultations with subject matter experts involved in definition of existing flight rules (several of whom had since left NASA), iv) relevant published literature, v) model estimates of tissue on-gassing and off-gassing, and vi) NASA’s operational experience with late breaks in prebreathe. RESULTS. NASA’s nominal prebreathe protocols are validated via extensive ground testing to ensure DCS risk is reduced to within acceptable limits. Conversely, there exists a paucity of data, no validated models, and limited documentation regarding BIP risk for NASA prebreathe protocols. Flight rules implemented for shuttle and later ISS are based primarily on expert opinion and an assumption of symmetric on-gassing and off-gassing, which would make 2:1 payback a conservative mitigation for a BIP. Assumption of exponential gas kinetics makes late breaks higher risk, or require greater payback, than earlier breaks. Two BIPs have occurred using the current ISS prebreathe protocol, each of which was followed by greater than 2:1 payback and at least 59 minutes of 100% O2 pre-depress. No DCS cases have been reported during shuttle or ISS EVA operations. DISCUSSION. Interim changes were implemented to protect against late breaks during ground and flight prebreathes by ensuring negligible difference in conservatively modeled ppN2 pre-depress compared to nominal validated protocols. Additional documentation and literature review as well as chamber test planning are ongoing with the objective of further ground and flight rule updates and validation of a BIP risk model.

Prebreathe↗
NASA NTRS2024

Updates to NASA’s Break-in-Prebreathe Rules Due to Type II Decompression Sickness Risk Considerations

INTRODUCTION. Investigation of a central neurological decompression sickness (DCS) case during ground testing at Johnson Space Center identified a break-in-prebreathe (BIP) 13 minutes prior to depressurization as the leading credible cause despite applicable prebreathe payback rules being followed. Applicable NASA rules, for ground and flight, directed 2:1 payback of breaks up to 10 mins in duration, regardless of when a break occurs relative to depress. Full restart of prebreathe is directed following breaks > 10 min. The adequacy of NASA’s BIP rules was evaluated prior to resuming hypobaric ground testing or ISS extravehicular activities. METHODS. The following information sources were reviewed prior to formulating recommendations: i) Type II DCS case report and investigation findings; ii) documented rationale for existing flight rules, iii) consultations with subject matter experts involved in definition of existing flight rules (several of whom had since left NASA), iv) relevant published literature, v) model estimates of tissue on-gassing and off-gassing, and vi) NASA’s operational experience with late breaks in prebreathe. RESULTS. NASA’s nominal prebreathe protocols are validated via extensive ground testing to ensure DCS risk is reduced to within acceptable limits. Conversely, there exists a paucity of data, no validated models, and limited documentation regarding BIP risk for NASA prebreathe protocols. Flight rules implemented for shuttle and later ISS are based primarily on expert opinion and an assumption of symmetric on-gassing and off-gassing, which would make 2:1 payback a conservative mitigation for a BIP. Assumption of exponential gas kinetics makes late breaks higher risk, or require greater payback, than earlier breaks. Two BIPs have occurred using the current ISS prebreathe protocol, each of which was followed by greater than 2:1 payback and at least 59 minutes of 100% O2 pre-depress. No DCS cases have been reported during shuttle or ISS EVA operations. DISCUSSION. Interim changes were implemented to protect against late breaks during ground and flight prebreathes by ensuring negligible difference in conservatively modeled ppN2 pre-depress compared to nominal validated protocols. Additional documentation and literature review as well as chamber test planning are ongoing with the objective of further ground and flight rule updates and validation of a BIP risk model.

Prebreathe↗
NASA NTRS2008

Description of the NASA Hypobaric Decompression Sickness Database (1982-1998)

The availability of high-speed computers, data analysis software, and internet communication are compelling reasons to describe and make available computer databases from many disciplines. Methods: Human research using hypobaric chambers to understand and then prevent decompression sickness (DCS) during space walks has been conducted at the Johnson Space Center (JSC) from 1982 to 1998. The data are archived in the NASA Hypobaric Decompression Sickness Database, within an Access 2003 Relational Database. Results: There are 548 records from 237 individuals that participated in 31 unique tests. Each record includes physical characteristics, the denitrogenation procedure that was tested, and the outcome of the test, such as the report of a DCS symptom and the intensity of venous gas emboli (VGE) detected with an ultrasound Doppler bubble detector as they travel in the venous blood along the pulmonary artery on the way to the lungs. We documented 84 cases of DCS and 226 cases where VGE were detected. The test altitudes were 10.2, 10.1, 6.5, 6.0, and 4.3 pounds per square inch absolute (psia). 346 records are from tests conducted at 4.3 psia, the operating pressure of the current U.S. space suit. 169 records evaluate the Staged 10.2 psia Decompression Protocol used by the Space Shuttle Program. The mean exposure time at altitude was 242.3 minutes (SD = 80.6), with a range from 120 to 360 minutes. Among our test subjects, 96 records of exposures are females. The mean age of all test subjects was 31.8 years (SD = 7.17), with a range from 20 to 54 years. Discussion: These data combined with other published databases and evaluated with metaanalysis techniques would extend our understanding about DCS. A better understanding about the cause and prevention of DCS would benefit astronauts, aviators, and divers.

Wessel, J. H., III↗
NASA NTRS1984

Verification of an altitude decompression sickness prevention protocol for Shuttle operations utilizing a 10.s psi pressure stage

Three test series involving 173-man tess were conducted to define and verify a pre-extravehicular activity (EVA) denitrogenation procedure that would provide acceptable protection against altitude decompression sickness while minimizing the required duration of oxygen (O2) prebreathe in the suit prior to EVA. The tests also addressed the safety, in terms of incidence of decompression sickness, of conducting EVA's on consecutive days rather than on alternate days. The tests were conducted in an altitude chamber, subjects were selected as representative of the astronaut population, and EVA periods were simulated by reducing the chamber pressure to suit pressure while the subjects breathed O2 with masks and worked at EVA representative work rates. A higher than anticipated incidence of both venous bubbles (55%) and symptoms (26%) was measured following all denitrogenation protocols in this test. For the most part, symptoms were very minor and stabilized, diminished, or disappeared in the six-hour tests. Instances of clear, possible, or potential systemic symptoms were encountered only after use of the unmodified 10.2 psi protocol and not after the modified 10.2 psi protocol, the 3.5-hour O2 prebreathed protocol, or the 4.0-hour O2 prebreathe protocol. The high incidence of symptoms is ascribed to the type and duration of exercise and the sensitivity of the reporting technique to minor symptoms. Repeated EVA exposures after only 17 hours did not increase symptom or bubble incidence.

Waligora, J. M.↗
NASA NTRS1975

Prevention of decompression sickness during a simulated space docking mission

This study has shown that repetitive exchanges between the Apollo space vehicle atmosphere of 100% oxygen at 5 psia (258 torr) and the Soyuz spacecraft atmosphere of 30% oxygen-70% nitrogen at 10 psia (533 torr), as simulated in altitude chambers, will not likely result in any form of decompression sickness. This conclusion is based upon the absence of any form of bends in seven crewmen who participated in 11 tests distributed over three 24-h periods. During each period, three transfers from the 5 to the 10 psia environments were performed by simulating passage through a docking module which served as an airlock where astronauts and cosmonauts first adapted to each other's cabin gases and pressures before transfer. Biochemical tests, subjective fatigue scores, and the complete absence of any form of pain were also indicative that decompression sickness should not be expected if this spacecraft transfer schedule is followed.

Cooke, J. P.↗
NASA NTRS2003

Gender not a factor for altitude decompression sickness risk

INTRODUCTION: Early, retrospective reports of the incidence of altitude decompression sickness (DCS) during altitude chamber training exposures indicated that women were more susceptible than men. We hypothesized that a controlled, prospective study would show no significant difference. METHODS: We conducted 25 altitude chamber decompression exposure profiles. A total of 291 human subjects, 197 men and 94 women, underwent 961 exposures to simulated altitude for up to 8 h, using zero to 4 h of preoxygenation. Throughout the exposures, subjects breathed 100% oxygen, rested or performed mild or strenuous exercise, and were monitored for precordial venous gas emboli (VGE) and DCS symptoms. RESULTS: No significant differences in DCS incidence were observed between men (49.5%) and women (45.3%). However, VGE occurred at significantly higher rates among men than women under the same exposure conditions, 69.3% and 55.0% respectively. Women using hormonal contraception showed significantly greater susceptibility to DCS than those not using hormonal contraception during the latter two weeks of the menstrual cycle. Significantly higher DCS incidence was observed in the heaviest men, in women with the highest body fat, and in subjects with the highest body mass indices and lowest levels of fitness. CONCLUSION: No differences in altitude DCS incidence were observed between the sexes under our test conditions, although men developed VGE more often than women. Age and height showed no significant influence on DCS incidence, but persons of either sex with higher body mass index and lower physical fitness developed DCS more frequently.

NASA Discipline Environmental Health↗