Results for “Injury” — Page 2

NASA NTRS2013

Estimated Probability of a Cervical Spine Injury During an ISS Mission

Introduction: The Integrated Medical Model (IMM) utilizes historical data, cohort data, and external simulations as input factors to provide estimates of crew health, resource utilization and mission outcomes. The Cervical Spine Injury Module (CSIM) is an external simulation designed to provide the IMM with parameter estimates for 1) a probability distribution function (PDF) of the incidence rate, 2) the mean incidence rate, and 3) the standard deviation associated with the mean resulting from injury/trauma of the neck. Methods: An injury mechanism based on an idealized low-velocity blunt impact to the superior posterior thorax of an ISS crewmember was used as the simulated mission environment. As a result of this impact, the cervical spine is inertially loaded from the mass of the head producing an extension-flexion motion deforming the soft tissues of the neck. A multibody biomechanical model was developed to estimate the kinematic and dynamic response of the head-neck system from a prescribed acceleration profile. Logistic regression was performed on a dataset containing AIS1 soft tissue neck injuries from rear-end automobile collisions with published Neck Injury Criterion values producing an injury transfer function (ITF). An injury event scenario (IES) was constructed such that crew 1 is moving through a primary or standard translation path transferring large volume equipment impacting stationary crew 2. The incidence rate for this IES was estimated from in-flight data and used to calculate the probability of occurrence. The uncertainty in the model input factors were estimated from representative datasets and expressed in terms of probability distributions. A Monte Carlo Method utilizing simple random sampling was employed to propagate both aleatory and epistemic uncertain factors. Scatterplots and partial correlation coefficients (PCC) were generated to determine input factor sensitivity. CSIM was developed in the SimMechanics/Simulink environment with a Monte Carlo wrapper (MATLAB) used to integrate the components of the module. Results: The probability of generating an AIS1 soft tissue neck injury from the extension/flexion motion induced by a low-velocity blunt impact to the superior posterior thorax was fitted with a lognormal PDF with mean 0.26409, standard deviation 0.11353, standard error of mean 0.00114, and 95% confidence interval [0.26186, 0.26631]. Combining the probability of an AIS1 injury with the probability of IES occurrence was fitted with a Johnson SI PDF with mean 0.02772, standard deviation 0.02012, standard error of mean 0.00020, and 95% confidence interval [0.02733, 0.02812]. The input factor sensitivity analysis in descending order was IES incidence rate, ITF regression coefficient 1, impactor initial velocity, ITF regression coefficient 2, and all others (equipment mass, crew 1 body mass, crew 2 body mass) insignificant. Verification and Validation (V&V): The IMM V&V, based upon NASA STD 7009, was implemented which included an assessment of the data sets used to build CSIM. The documentation maintained includes source code comments and a technical report. The software code and documentation is under Subversion configuration management. Kinematic validation was performed by comparing the biomechanical model output to established corridors.

Brooker, John E.↗

NASA NTRS2014

FY13 High Performance EVA Glove (HPEG) Collaboration: Glove Injury Data Mining Effort - Training Data Overview

From the time hand-intensive tasks were first created for EVAs, discomforts and injuries have been noted.. There have been numerous versions of EVA gloves for US crew over the past 50 years, yet pain and injuries persist. The investigation team was tasked with assisting in a glove injury assessment for the High Performance EVA Glove (HPEG) project.center dot To aid in this assessment, the team was asked to complete the following objectives: - First, to develop the best current understanding of what glove-related injuries have occurred to date, and when possible, identify the specific mechanisms that caused those injuries - Second, to create a standardized method for comparison of glove injury potential from one glove to another. center dot The overall goal of the gloved hand injury assessment is to utilize ergonomics in understanding how these glove injuries are occurring, and to propose mitigations to current designs or design changes in the next generation of EVA gloves.

Reid, Christopher↗

NASA NTRS2004

Results from an Investigation into Extra-Vehicular Activity (EVA) Training Related Shoulder Injuries

The number and complexity of extravehicular activities (EVAs) required for the completion and maintenance of the International Space Station (ISS) is unprecedented. The training required to successfully complete this magnitude of space walks presents a real risk of overuse musculoskeletal injuries to the EVA crew population. There was mounting evidence raised by crewmembers, trainers, and physicians at the Johnson Space Center (JSC) between 1999 and 2002 that suggested a link between training in the Neutral - Buoyancy Lab (NBL) and the several reported cases of shoulder injuries. The short- and long-term health consequences of shoulder injury to astronauts in training as well as the potential mission impact associated with surgical intervention to assigned EVA crew point to this as a critical problem that must be mitigated. Thus, a multi-directorate tiger team was formed in December of 2002 led by the EVA Office and Astronaut Office at the JSC. The primary objectives of this Tiger Team were to evaluate the prevalence of these injuries and substantiate the relationship to training in the NBL with the crew person operating in the EVA Mobility Unit (EMU). Between December 2002 and June of 2003 the team collected data, surveyed crewmembers, consulted with a variety of physicians, and performed tests. The results of this effort were combined with the vast knowledge and experience of the Tiger Team members to formulate several findings and over fifty recommendations. This paper summarizes those findings and recommendations as well as the process by which these were determined. The Tiger Team concluded that training in the NBL was directly linked to several major and minor shoulder injuries that had occurred. With the assistance of JSC flight surgeons, outside consultants, and the lead crewmember/physician on the team, the mechanisms of injury were determined. These mechanisms were then linked to specific aspects of the hardware design, operational techniques, and the training environment. During the 1999 to 2003 time frame many variables converged to make it impossible to determine with any accuracy which one or two root causes were primarily involved. Therefore a broad range of recommendations was established to prevent future injury to crewmembers training in the NBL in the near term. Many of these recommendations are lessons learned that are essentially timeless and therefore should be passed on to future EVA endeavors to ensure that hardware designs and operational techniques utilized in the future consider the demands of training on the human body here on earth.

Johnson, Brian J.↗

NASA NTRS2011

Shoulder Injuries in US Astronauts Related to EVA Suit Design

Introduction: For every one hour spent performing extravehicular activity (EVA) in space, astronauts in the US space program spend approximately six to ten hours training in the EVA spacesuit at NASA-Johnson Space Center's Neutral Buoyancy Lab (NBL). In 1997, NASA introduced the planar hard upper torso (HUT) EVA spacesuit which subsequently replaced the existing pivoted HUT. An extra joint in the pivoted shoulder allows increased mobility but also increased complexity. Over the next decade a number of astronauts developed shoulder problems requiring surgical intervention, many of whom performed EVA training in the NBL. This study investigated whether changing HUT designs led to shoulder injuries requiring surgical repair. Methods: US astronaut EVA training data and spacesuit design employed were analyzed from the NBL data. Shoulder surgery data was acquired from the medical record database, and causal mechanisms were obtained from personal interviews Analysis of the individual HUT designs was performed as it related to normal shoulder biomechanics. Results: To date, 23 US astronauts have required 25 shoulder surgeries. Approximately 48% (11/23) directly attributed their injury to training in the planar HUT, whereas none attributed their injury to training in the pivoted HUT. The planar HUT design limits shoulder abduction to 90 degrees compared to approximately 120 degrees in the pivoted HUT. The planar HUT also forces the shoulder into a forward flexed position requiring active retraction and extension to increase abduction beyond 90 degrees. Discussion: Multiple factors are associated with mechanisms leading to shoulder injury requiring surgical repair. Limitations to normal shoulder mechanics, suit fit, donning/doffing, body position, pre-existing injury, tool weight and configuration, age, in-suit activity, and HUT design have all been identified as potential sources of injury. Conclusion: Crewmembers with pre-existing or current shoulder injuries or certain anthropometric body types should conduct NBL EVA training in the pivoted HUT.

Scheuring, R. A.↗

NASA NTRS2014

Data Mining of Historical Human Data to Assess the Risk of Injury due to Dynamic Loads

The NASA Occupant Protection Group is charged with ensuring crewmembers are protected during all dynamic phases of spaceflight. Previous work with outside experts has led to the development of a definition of acceptable risk (DAR) for space capsule vehicles. The DAR defines allowable probability rates for various categories of injuries. An important question is how to validate these probabilities for a given vehicle. One approach is to impact test human volunteers under projected nominal landing loads. The main drawback is the large number of subject tests required to attain a reasonable level of confidence that the injury probability rates would meet those outlined in the DAR. An alternative is to mine existing databases containing human responses to impact. Testing an anthropomorphic test device (ATD) at the same human‐exposure levels could yield a range of ATD responses that would meet DAR. As one aspect of future vehicle validation, the ATD could be tested in the vehicle's seat and suit configuration at nominal landing loads and compared with the ATD responses supported by the human data set. This approach could reduce the number of human‐volunteer tests NASA would need to conduct to validate that a vehicle meets occupant protection standards. METHODS: The U.S. Air Force has recorded hundreds of human responses to frontal, lateral, and spinal impacts at many acceleration levels and pulse durations. All of this data are stored on the Collaborative Biomechanics Data Network (CBDN), which is maintained by the Wright Patterson Air Force Base (WPAFB). The test device for human occupant restraint (THOR) ATD was impact tested on WPAFB's horizontal impulse accelerator (HIA) matching human‐volunteer exposures on the HIA to 5 frontal and 3 spinal loading conditions. No human injuries occurred as a result of these impact conditions. Peak THOR response variables for neck axial tension and compression, and thoracic‐spine axial compression were collected. Maximal chest deflection was determined from motion capture video of the impact test. HIC‐ 15 and BRIC were calculated from head acceleration responses. Given the number of human subjects for each test condition a confidence interval of injury probability will be obtained. RESULTS: Results will be discussed in terms of injury‐risk probability estimates based on the human data set evaluated. Also, gaps in the data set will be identified. These gaps could be one of two types. One is areas where additional THOR testing would increase the comparable human data set, thereby improving confidence in the injury probability rate. The other is where additional human testing would assist in obtaining information on other acceleration levels or directions. DISCUSSION: The historical human data showed validity of the THOR ATD for supplemental testing. The historical human data are limited in scope, however. Further data are needed to characterize the effects of sex, age, anthropometry, and deconditioning due to spaceflight on risk of injury

Wells, Jesica↗

NASA NTRSDate not supplied

Study of Advanced Occupant Models to Quantify Injury Risk for eVTOL Vehicles

Urban transportation is currently evolving from traditional ground-based vehicles (cars, taxis, and buses) to include air-based electric vertical take-off and landing (eVTOL) vehicles which can be utilized for on-demand transportation, cargo transport, and emergency services. These new eVTOL vehicles are designed to be small, lightweight, and able to operate autonomously without user intervention. Safety is a big part of eventual eVTOL adoption, however gaps in the consideration of safety features exist. Anthropomorphic test devices (ATDs) are used in aerospace crashworthiness standards to quantify occupant injury risk and develop improved safety designs for emergency landing situations, but the ATDs currently used in aircraft certification requirements were developed many decades ago. Developments have occurred over the years involving ATD technology, which includes a host of newer and more biofidelic ATDs such as the Test Device for Human Occupant Restraint (THOR). Increased computing power has also allowed for detailed computational human body models (HBMs) to be created, such as the Global Human Body Model Consortium (GHBMC). This study aims to assess the capability of both HBMs and new ATD designs to identify injury mechanisms within eVTOL relevant emergency landing conditions. Finite element (FE) analysis was used to expand upon full-scale and seat level impact testing conducted by researchers at the National Aeronautics and Space Administration (NASA) to look at effects of occupant model configurations on prediction of injury. The GHBMC HBM and THOR ATD models were simulated in the seat level test conditions to characterize differences between these advanced assessment tools and traditional ATDs in the isolated seat loading environment. Results identified key differences in the responses from each of the models utilized and compared their impact response in head, neck, and spinal injury metrics. The THOR model identified potential risks for head injuries due to head impacts on the seat, however it predicted lower spinal loads than the other occupant surrogates. The GHBMC showed distinctly different biomechanical responses compared to the ATD. The GHBMC model is much more deformable than the ATDs and it exhibited higher distribution of forces and increased sensitivity to the duration of acceleration pulses. Both models incorporated into this study identified key mechanisms for injury that should be considered for passenger safety in the development of these novel aircraft. In addition, this study demonstrated the value of FE modeling for running a variety of complex human surrogates to identify potential injury mechanisms for consideration in regulation and development of new aircraft. Continued research in this field to improve validation these models will only lead to safer aircraft and more comprehensive safety measures.

Crashworthiness↗

NASA NTRSDate not supplied

Study of Advanced Occupant Models to Quantify Injury Risk for eVTOL Vehicles

Urban transportation is currently evolving from traditional ground-based vehicles (cars, taxis, and buses) to include air-based electric vertical take-off and landing (eVTOL) vehicles which can be utilized for on-demand transportation, cargo transport, and emergency services. These new eVTOL vehicles are designed to be small, lightweight, and able to operate autonomously without user intervention. Safety is a big part of eventual eVTOL adoption, however gaps in the consideration of safety features exist. Anthropomorphic test devices (ATDs) are used in aerospace crashworthiness standards to quantify occupant injury risk and develop improved safety designs for emergency landing situations, but the ATDs currently used in aircraft certification requirements were developed many decades ago. Developments have occurred over the years involving ATD technology, which includes a host of newer and more biofidelic ATDs such as the Test Device for Human Occupant Restraint (THOR). Increased computing power has also allowed for detailed computational human body models (HBMs) to be created, such as the Global Human Body Model Consortium (GHBMC). This study aims to assess the capability of both HBMs and new ATD designs to identify injury mechanisms within eVTOL relevant emergency landing conditions. Finite element (FE) analysis was used to expand upon full-scale and seat level impact testing conducted by researchers at the National Aeronautics and Space Administration (NASA) to look at effects of occupant model configurations on prediction of injury. The GHBMC HBM and THOR ATD models were simulated in the seat level test conditions to characterize differences between these advanced assessment tools and traditional ATDs in the isolated seat loading environment. Results identified key differences in the responses from each of the models utilized and compared their impact response in head, neck, and spinal injury metrics. The THOR model identified potential risks for head injuries due to head impacts on the seat, however it predicted lower spinal loads than the other occupant surrogates. The GHBMC showed distinctly different biomechanical responses compared to the ATD. The GHBMC model is much more deformable than the ATDs and it exhibited higher distribution of forces and increased sensitivity to the duration of acceleration pulses. Both models incorporated into this study identified key mechanisms for injury that should be considered for passenger safety in the development of these novel aircraft. In addition, this study demonstrated the value of FE modeling for running a variety of complex human surrogates to identify potential injury mechanisms for consideration in regulation and development of new aircraft. Continued research in this field to improve validation these models will only lead to safer aircraft and more comprehensive safety measures.

Crashworthiness↗

NASA NTRS2003

EMU Shoulder Injury Tiger Team Report

The number and complexity of extravehicular activities required for the completion and maintenance of the International Space Station is unprecedented. It is not surprising that training to perform these space walks presents a risk of overuse musculoskeletal injuries. The goal of this tiger team, created in December 2002, was to identify the different factors contributing to the risk of EVA training-related shoulder injury in the Neutral Buoyancy Lab at the Sonny Carter Training Facility and to make recommendations that would either significantly reduce or eliminate those risks. Since 1999, concerns have been expressed about the risk of shoulder injury associated with EVA training at the NBL, particularly in inverted body positions (McMonigal, 1999). A survey was developed and administered to 42 astronauts and astronaut candidates; the results suggest a causal relationship between EVA training at the NBL and the observed injuries. Also, during the tiger team review, it became evident that training in the extravehicular mobility unit may also result in other types of injuries, including fingernail delamination, elbow pain, knee pain, foot pain, and nerve compression leading to transient loss of sensation in certain areas of the upper or lower extremity. A multi-directorate team to detect, evaluate and respond to the medical issues associated with EVA training should be implemented immediately and given the appropriate resources and authority to reduce the risk of injury to crew during training to a level as low as reasonably achievable.

Williams, David R.↗

NASA NTRS2015

Final NASA Panel Recommendations for Definition of Acceptable Risk of Injury Due to Spaceflight Dynamic Events

A panel of experts was convened in 2010 to help define acceptable injury risk levels for space vehicle launches, landings, and abort scenarios. Classifications of spaceflight-relevant injuries were defined using four categories ranging from minor to severe injury. Limits for each injury category were agreed to, dependent on the expected number of crew exposures in a given vehicle and on whether the flight was considered nominal or off-nominal. Somers et al. captured the findings of this summit in a NASA technical memorandum. This panel was recently re-convened (December 1, 2014) to determine whether the previous recommended injury limits were applicable to newly-designed commercial space flight vehicles. In particular, previous limits were based in part on the number of crew exposures per vehicle and also were sensitive to a definition of nominal and off-nominal vehicle performance. Reconsideration of these aspects led to a new consensus on a definition of injury risk.

Somers, Jeffrey T.↗

NASA NTRS2022

Astronaut Kinematics and Injury Risk for Piloted Lunar Landings and Launches While Standing

During future lunar missions, astronauts may be required to pilot vehicles while standing, and the associated kinematic and injury response is not well understood. In this study we used human body modeling to predict unsuited astronaut kinematics and injury risk for piloted lunar launches and landings in the standing posture. Three pulses (2-5 g; 10–150 ms rise times) were applied in 10 directions (vertical; ± 10-degree offsets) for a total of 30 simulations. Across all simulations, motion envelopes were computed to quantify displacement of the astronaut’s head (max 9.0 cm forward, 7.0 cm backward, 2.1 cm upward, 7.3 cm downward, 2.4 cm lateral) and arms (max 25 cm forward, 35 cm backward, 15 cm upward, 20 cm downward, 20 cm lateral). All head, neck, lumbar, and lower extremity injury metrics were within NASA’s tolerance limits, except tibia compression forces (0–1543 N upper tibia; 0–1482 N lower tibia; tolerance—1350 N) and revised tibia index (0.04–0.58 upper tibia; 0.03–0.48 lower tibia; tolerance—0.43) for the 2.7 g/150 ms pulse. Pulse magnitude and duration contributed over 80% to the injury metric values, whereas loading direction contributed less than 3%. Overall, these simulations suggest piloting a lunar lander vehicle in the standing posture presents a low risk of injury to the astronaut, although risk of tibia injury is potentially outside NASA’s acceptance limits and warrants further investigation.

Mitesh Lalwala↗

DOE OSTI2025

Single cell RNA sequencing reveals shifts in cell maturity and function of endogenous and infiltrating cell types in response to acute intervertebral disc injury

Intervertebral disc (IVD) degeneration contributes to disabling back pain. Degeneration can be initiated by injury and progressively leads to an irreversible loss of cells and function. IVD function restoration through cell replacement therapies have had limited success due to knowledge gaps in the critical cell populations important for repair. Here, in this study, we used single cell RNA sequencing to identify the transcriptional changes of IVD resident and infiltrating cell populations from Control and Injured coccygeal IVDs extracted from 12-week-old female C57BL/6J mice 7 days post injury. Clustering, gene ontology, and pseudotime trajectory analyses determined transcriptomic divergences with injury, flow cytometry identified they types of infiltrating immune cells, and immunofluorescence was utilized to define mesenchymal stem cell (MSC) localization. We identified 11 distinct clusters that included IVD, immune, vascular cells, and MSCs. Differential gene expression analysis determined that Outer Annulus Fibrosus, Neutrophils, Saa2-High MSCs, Macrophages, and Krt18 + Nucleus Pulposus (NP) cells were the major drivers of transcriptomic differences between Control and Injured cells. Gene ontology revealed that the most upregulated biological pathways were angiogenesis and T cell-related while wound healing and ECM regulation were downregulated. Pseudotime trajectory analyses revealed that IVD injury directed cells towards increased differentiation in all clusters, except for Krt18 + NP cells which remained in a less mature cell state. Saa2-High and Grem1-High MSCs populations shifted towards more differentiated IVD cells profiles with injury and localized distinctly within the IVD. This study revealed novel MSC populations with the potential to be leveraged for future IVD repair studies.

Cartilage↗

DOE OSTI2024

Comparative Performance of Three Eye-Tracking Devices in Detection of Mild Traumatic Brain Injury in Acute Versus Chronic Subject Populations

ABSTRACT Introduction Presently, traumatic brain injury (TBI) triage in field settings relies on symptom-based screening tools such as the updated Military Acute Concussion Evaluation. Objective eye-tracking may provide an alternative means of neurotrauma screening due to sensitivity to neurotrauma brain-health changes. Previously, the US Army Medical Research and Development Command Non-Invasive NeuroAssessment Devices (NINAD) Integrated Product Team identified 3 commercially available eye-tracking devices (SyncThink EYE-SYNC, Oculogica EyeBOX, NeuroKinetics IPAS) as meeting criteria toward being operationally effective in the detection of TBI in service members. We compared these devices to assess their relative performance in the classification of mild traumatic brain injury (mTBI) subjects versus normal healthy controls. Materials and Methods Participants 18 to 45 years of age were assigned to Acute mTBI, Chronic mTBI, or Control group per study criteria. Each completed a TBI assessment protocol with all 3 devices counterbalanced across participants. Acute mTBI participants were tested within 72 hours following injury whereas time since last injury for the Chronic mTBI group ranged from months to years. Discriminant analysis was undertaken to determine device classification performance in separating TBI subjects from controls. Area Under the Curves (AUCs) were calculated and used to compare the accuracy of device performance. Device-related factors including data quality, the need to repeat tests, and technical issues experienced were aggregated for reporting. Results A total of 63 participants were recruited as Acute mTBI subjects, 34 as Chronic mTBI subjects, and 119 participants without history of TBI as controls. To maximize outcomes, poorer quality data were excluded from analysis using specific criteria where possible. Final analysis utilized 49 (43 male/6 female, mean [x̅] age = 24.3 years, SD [s] = 5.1) Acute mTBI subjects, and 34 (33 male/1 female, x̅ age = 38.8 years, s = 3.9) Chronic mTBI subjects were age- and gender-matched as closely as possible with Control subjects. AUCs obtained with 80% of total dataset ranged from 0.690 to 0.950 for the Acute Group and from 0.753 to 0.811 for the Chronic mTBI group. Validation with the remaining 20% of dataset produced AUCs ranging from 0.600 to 0.750 for Acute mTBI group and 0.490 to 0.571 for the Chronic mTBI group. Conclusions Potential eye-tracking detection of mTBI, per training model outcomes, ranged from acceptable to excellent for the Acute mTBI group; however, it was less consistent for the Chronic mTBI group. The self-imposed targeted performance (AUC of 0.850) appears achievable, but further device improvements and research are necessary. Discriminant analysis models differed for the Acute versus Chronic mTBI groups, suggesting performance differences in eye-tracking. Although eye-tracking demonstrated sensitivity in the Chronic group, a more rigorous and/or longitudinal study design is required to evaluate this observation. mTBI injuries were not controlled for this study, potentially reducing eye-tracking assessment sensitivity. Overall, these findings indicate that while eye-tracking remains a viable means of mTBI screening, device-specific variability in data quality, length of testing, and ease of use must be addressed to achieve NINAD objectives and DoD implementation.

General & Internal Medicine↗

DOE OSTI2024

Drug-induced kidney injury: challenges and opportunities

Abstract Drug-induced kidney injury (DIKI) is a frequently reported adverse event, associated with acute kidney injury, chronic kidney disease, and end-stage renal failure. Prospective cohort studies on acute injuries suggest a frequency of around 14%–26% in adult populations and a significant concern in pediatrics with a frequency of 16% being attributed to a drug. In drug discovery and development, renal injury accounts for 8 and 9% of preclinical and clinical failures, respectively, impacting multiple therapeutic areas. Currently, the standard biomarkers for identifying DIKI are serum creatinine and blood urea nitrogen. However, both markers lack the sensitivity and specificity to detect nephrotoxicity prior to a significant loss of renal function. Consequently, there is a pressing need for the development of alternative methods to reliably predict drug-induced kidney injury (DIKI) in early drug discovery. In this article, we discuss various aspects of DIKI and how it is assessed in preclinical models and in the clinical setting, including the challenges posed by translating animal data to humans. We then examine the urinary biomarkers accepted by both the US Food and Drug Administration (FDA) and the European Medicines Agency for monitoring DIKI in preclinical studies and on a case-by-case basis in clinical trials. We also review new approach methodologies (NAMs) and how they may assist in developing novel biomarkers for DIKI that can be used earlier in drug discovery and development.

Connor, Skylar (ORCID:0000000233479180)↗

NASA NTRS2002

Effects of perfluorohexane vapor on relative blood flow distribution in an animal model of surfactant-depleted lung injury

OBJECTIVE: To test the hypothesis that treatment with vaporized perfluorocarbon affects the relative pulmonary blood flow distribution in an animal model of surfactant-depleted acute lung injury. DESIGN: Prospective, randomized, controlled trial. SETTING: A university research laboratory. SUBJECTS: Fourteen New Zealand White rabbits (weighing 3.0-4.5 kg). INTERVENTIONS: The animals were ventilated with an FIO(2) of 1.0 before induction of acute lung injury. Acute lung injury was induced by repeated saline lung lavages. Eight rabbits were randomized to 60 mins of treatment with an inspiratory perfluorohexane vapor concentration of 0.2 in oxygen. To compensate for the reduced FIO(2) during perfluorohexane treatment, FIO(2) was reduced to 0.8 in control animals. Change in relative pulmonary blood flow distribution was assessed by using fluorescent-labeled microspheres. MEASUREMENTS AND MAIN RESULTS: Microsphere data showed a redistribution of relative pulmonary blood flow attributable to depletion of surfactant. Relative pulmonary blood flow shifted from areas that were initially high-flow to areas that were initially low-flow. During the study period, relative pulmonary blood flow of high-flow areas decreased further in the control group, whereas it increased in the treatment group. This difference was statistically significant between the groups (p =.02) as well as in the treatment group compared with the initial injury (p =.03). Shunt increased in both groups over time (control group, 30% +/- 10% to 63% +/- 20%; treatment group, 37% +/- 20% to 49% +/- 23%), but the changes compared with injury were significantly less in the treatment group (p =.03). CONCLUSION: Short treatment with perfluorohexane vapor partially reversed the shift of relative pulmonary blood flow from high-flow to low-flow areas attributable to surfactant depletion.

NASA Discipline Cardiopulmonary↗

NASA NTRS1991

Neuroendocrine abnormalities in patients with traumatic brain injury

This article provides an overview of hypothalamic and pituitary alterations in brain trauma, including the incidence of hypothalamic-pituitary damage, injury mechanisms, features of the hypothalamic-pituitary defects, and major hypothalamic-pituitary disturbances in brain trauma. While hypothalamic-pituitary lesions have been commonly described at postmortem examination, only a limited number of clinical cases of traumatic hypothalamic-pituitary dysfunction have been reported, probably because head injury of sufficient severity to cause hypothalamic and pituitary damage usually leads to early death. With the improvement in rescue measures, an increasing number of severely head-injured patients with hypothalamic-pituitary dysfunction will survive to be seen by clinicians. Patterns of endocrine abnormalities following brain trauma vary depending on whether the injury site is in the hypothalamus, the anterior or posterior pituitary, or the upper or lower portion of the pituitary stalk. Injury predominantly to the hypothalamus can produce dissociated ACTH-cortisol levels with no response to insulin-induced hypoglycemia and a limited or failed metopirone test, hypothyroxinemia with a preserved thyroid-stimulating hormone response to thyrotropin-releasing hormone, low gonadotropin levels with a normal response to gonadotropin-releasing hormone, a variable growth hormone (GH) level with a paradoxical rise in GH after glucose loading, hyperprolactinemia, the syndrome of inappropriate ADH secretion (SIADH), temporary or permanent diabetes insipidus (DI), disturbed glucose metabolism, and loss of body temperature control. Severe damage to the lower pituitary stalk or anterior lobe can cause low basal levels of all anterior pituitary hormones and eliminate responses to their releasing factors. Only a few cases showed typical features of hypothalamic or pituitary dysfunction. Most severe injuries are sufficient to damage both structures and produce a mixed endocrine picture. Increased intracranial pressure, which releases vasopressin by altering normal hypothalamic anatomy, may represent a unique type of stress to neuroendocrine systems and may contribute to adrenal secretion by a mechanism that requires intact brainstem function. Endocrine function should be monitored in brain-injured patients with basilar skull fractures and protracted posttraumatic amnesia, and patients with SIADH or DI should be closely monitored for other endocrine abnormalities.

NASA Program Space Physiology and Countermeasures↗

NASA NTRS2008

Orion Crew Member Injury Predictions during Land and Water Landings

A review of astronaut whole body impact tolerance is discussed for land or water landings of the next generation manned space capsule named Orion. LS-DYNA simulations of Orion capsule landings are performed to produce a low, moderate, and high probability of injury. The paper evaluates finite element (FE) seat and occupant simulations for assessing injury risk for the Orion crew and compares these simulations to whole body injury models commonly referred to as the Brinkley criteria. The FE seat and crash dummy models allow for varying the occupant restraint systems, cushion materials, side constraints, flailing of limbs, and detailed seat/occupant interactions to minimize landing injuries to the crew. The FE crash test dummies used in conjunction with the Brinkley criteria provides a useful set of tools for predicting potential crew injuries during vehicle landings.

Lawrence, Charles↗

NASA NTRS2008

The Use of a Vehicle Acceleration Exposure Limit Model and a Finite Element Crash Test Dummy Model to Evaluate the Risk of Injuries During Orion Crew Module Landings

A review of astronaut whole body impact tolerance is discussed for land or water landings of the next generation manned space capsule named Orion. LS-DYNA simulations of Orion capsule landings are performed to produce a low, moderate, and high probability of injury. The paper evaluates finite element (FE) seat and occupant simulations for assessing injury risk for the Orion crew and compares these simulations to whole body injury models commonly referred to as the Brinkley criteria. The FE seat and crash dummy models allow for varying the occupant restraint systems, cushion materials, side constraints, flailing of limbs, and detailed seat/occupant interactions to minimize landing injuries to the crew. The FE crash test dummies used in conjunction with the Brinkley criteria provides a useful set of tools for predicting potential crew injuries during vehicle landings.

Lawrence, Charles↗

NASA NTRS2008

Orion Crew Member Injury Predictions during Land and Water Landings

A review of astronaut whole body impact tolerance is discussed for land or water landings of the next generation manned space capsule named Orion. LS-DYNA simulations of Orion capsule landings are performed to produce a low, moderate, and high probability of injury. The paper evaluates finite element (FE) seat and occupant simulations for assessing injury risk for the Orion crew and compares these simulations to whole body injury models commonly referred to as the Brinkley criteria. The FE seat and crash dummy models allow for varying the occupant restraint systems, cushion materials, side constraints, flailing of limbs, and detailed seat/occupant interactions to minimize landing injuries to the crew. The FE crash test dummies used in conjunction with the Brinkley criteria provides a useful set of tools for predicting potential crew injuries during vehicle landings.

Lawrence, Charles↗