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All sourcesNASA NTRSDOE OSTI
NASA NTRSDate not supplied

Development Testing of the Gateway Integrated Bipropellant Refueling Subsystem

The Lunar Gateway is a deep space orbiting outpost being developed by the National Aeronautics and Space Administration (NASA) in partnership with the European Space Agency (ESA) and other domestic and international partners. Because Gateway is a vital component of NASA’s Artemis program supporting long-term human exploration of the moon, it is designed for on-orbit refueling to allow for a longer life performance. The reaction control system (RCS) bipropellant refueling system onboard the station will have the capability to transfer propellants, monomethyl hydrazine (MMH) and mixed oxides of nitrogen-3 (MON-3), under controlled conditions and will span across three modules: the European System Providing Refueling Infrastructure and Telecommunication Refueling Module (ESPRIT-RM or ERM), the Habitation and Logistics Outpost (HALO), and the Propulsion and Power Element (PPE). These propellant transfers are complex operations with known hazards, and one of the risk areas is exceeding the flight system’s maximum design pressure (MDP) in priming and refueling pause/stop operations. In priming, liquid propellant is transferred from a pressurized source tank to evacuated transfer lines, which could result in excessive transient surge pressures and potentially damage hardware. In refueling pause/stop operations, fast-acting isolation valves (IV) are closed, which could lead to damaging water hammer. To mitigate these risks and develop the system, a collaborative NASA/ESA/Thales Alenia Space – United Kingdom (TAS-UK) test program was completed at TAS-UK on a simplified refueling breadboard representing ERM, HALO, and PPE bipropellant transfer systems. The objectives of the integrated breadboard testing were to (1) gather performance data to characterize and demonstrate critical refueling operations, (2) help inform flight designs, and (3) to validate numerical models that can be extended to predicting flight system performance. Integrated breadboard test data has shown the architected system performance is closing initial design assumptions. Further testing with propellant on a higher fidelity fluid simulator and analysis are planned.

Adela D Han↗
NASA NTRS2023

Exploration Medical Capability Clinical Decision Support Use Cases for CDSS Test Bed

Long-duration, deep-space exploration missions present significant challenges to crew health and performance. These challenges include the individual and combined effects of microgravity, radiation exposure, isolation, limited resources (mass, volume, power, data, and crew time), limited options for evacuation, and those associated with delayed or constrained communications. Each of these challenges necessitates greater degrees of crew autonomy as our distance from Earth increases. Specifically, as communication delays intensify - and evacuation capability diminishes the further we explore space - the unqualified need for Earth-independent medical operations focused on autonomous diagnosis, treatment and prevention will become key to mission continuation and success. This need will be especially true should a crewmember become ill or injured wherein treatment and disposition “in-situ” ultimately falls to the crew itself to determine. To augment the requisite knowledge, skills, and abilities (KSAs) of a time-constrained exploration mission crew operating under stressful conditions, combatting fatigue, and facing a potential medical crisis, a robust clinical decision support system (CDSS) is a probable solution. A CDSS would facilitate, guide, and inform Earth-independent medical operations while assisting crewmembers through various clinical presentations. The CDSS would allow crewmembers to take advantage of pre-mission training tied to the in-flight/in-mission use of pre-planned protocols that offer both a range of diagnostic options and “just-in-time” (refamiliarization) training and assistance. CDSS will expand such capabilities by improving the utility and effectiveness of various available diagnostic, treatment, and health maintenance tools, techniques, and measures.

ExMC↗
NASA NTRSDate not supplied

Impact Outputs for A Representative Extended Duration Artemis Mission

BACKGROUND: As NASA and private industry begin preparation for long-duration spaceflight, quantifying the impact that potential human health and performance capabilities have on crew health outcomes is imperative for medical risk mitigation. NASA’s Informing Mission Planning via Analysis of Complex Tradespaces tool (IMPACT) applies Probabilistic Risk Assessment (PRA) methodology to estimate these outcomes. OVERVIEW: As NASA prepares to return to the Moon, medical system planning has already begun for extended Artemis missions, which will see humans spending months at a time in cis-lunar space and on the surface of the Moon. The Long Duration Lunar Orbital and Lunar Surface (LDLOLS) design reference mission (DRM) lasts 9 months, including 3 months on the lunar surface, and involves 2 male and 2 female crewmembers. LDLOLS assumes no extravehicular activities (EVAs) in orbit, but, while on the lunar surface, involves 2-4 EVAs/month in a pressurized rover and 2-4 EVAs/month in an unpressurized rover or on foot. This DRM assumes a physician level Crew Medical Officer with commensurate knowledge, skills, and abilities. The IMPACT tool was utilized to estimate in-flight medical risk for this mission. More specifically, 100,000 simulations of this DRM were modeled, and overall estimates for loss of crew life (LOCL), need for evacuation (RTDC; return to definitive care), and crew task time lost (TTL; a measure of disability) were calculated. A recommended medical capability set, with appropriate mass and volume constraints, was also generated. DISCUSSION: This abstract reviews the IMPACT-derived risk for these mission outcomes with and without treatment, a macroscopic look at the total mass and volume necessary for full diagnostic and treatment capability, and how these change with input mission parameters.

J G Steller↗
NASA NTRS2025

Human Spaceflight Applications of Novel Miniature X-Ray Technologies

INTRODUCTION: Radiography (XR) has long been a cornerstone of terrestrial medical imaging, though it has not yet been used in the spaceflight environment. Medical systems for human spaceflight missions are constrained by mass, volume, and power, and until recently, XR systems have been considered too large and power-consuming for spaceflight diagnostic and therapeutic applications. However, the rise of commercial spaceflight and NASA’s refocused efforts on returning crews to the Moon for long-duration missions have introduced a higher degree of medical risk to human spaceflight and require a re-evaluation when optimizing medical system design. Over the last decade, XR devices have miniaturized while maintaining good diagnostic and therapeutic sensitivity and specificity, making new in-flight medical and non-medical XR applications a possibility. Initial research identified several medical conditions where miniature XR would be beneficial for the diagnosis and/or management of medical conditions arising in space, though a more in-depth analysis is required to identify whether XR may add value to the management of such conditions. With this presentation, we aim to introduce the potential utility of miniature XR, review prior work highlighting where XR may be beneficial, and evaluate how miniature XR may reduce medical risk in human spaceflight missions. METHODS: IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a risk assessment tool developed by NASA to advance exploration mission medical system design by quantitatively estimating mission medical risk. IMPACT v1.0 includes a novel evidence library baselined to exploration environments, an expanded list of 119 medical conditions, medical capabilities and resources critical for management of these medical conditions, and the ability for rapid and iterative analysis in the setting of modifiable design reference missions (DRMs). Our first analysis identified which of the 119 medical conditions XR had diagnostic or therapeutic utility for. Subject matter experts (SMEs) recorded which XR views would be performed under ideal terrestrial circumstances for diagnosis/management of each condition, as well as which views are pragmatic for spaceflight limitations. A second analysis utilized IMPACT to identify significant conditions that contribute greatest to medical risk during a notional long-duration Lunar orbit and Lunar surface DRM. Medical system risk estimates include loss of crew life (LOCL), need for return to definitive care (RTDC; medical evacuation), and an estimate of crew task time affected (TTA). Using a standardized semi-quantitative scoring methodology, a deeper evaluation of each of the most significant medical conditions was performed. Data from both of these separate analyses were used to hypothesize what ideal and pragmatic XR studies may impact clinical management of the most significant conditions predicted to lead to medical risk. RESULTS: Approximately 1/3 of the IMPACT conditions were identified as being more effectively or comprehensively assessed or treated with the addition of miniature XR technology. The resulting conditions benefitting diagnostically and therapeutically from XR are revealed, as well as the ideal and pragmatic XR views and medical procedures benefitting from XR. The conditions of clinical significance and those most contributing to risk are also displayed. Among the conditions that contribute greatest to LOCL, four conditions for which XR may improve the diagnosis and management of include: decompression sickness, traumatic shock, dental abscess, and respiratory failure. Among conditions that contributed to RTDC, the evaluation and management of wrist fracture is likely improved by XR. For conditions leading to crew TTA, evaluation and management of EVA shoulder injuries, upper and lower extremity strains, back strains, and EVA hand injuries are likely improved by XR. DISCUSSION: Miniature XR in spaceflight has the potential to improve the evaluation and management of a substantial portion of conditions that most contribute to medical risk. This presentation is an introduction to the possibilities miniature XR provides for future human spaceflight missions and subsequent presenters will expand on potential applications in more detail. LEARNING OBJECTIVES: 1) Understand the previous limitations of using radiography in the management of spaceflight medical conditions; 2) Evaluate the findings from the IMPACT tool analysis, which allows quantification of the benefit miniature XR could provide for managing high-risk medical conditions in long-duration lunar orbit and surface missions, focusing on improvements in crew health outcomes; 3) Analyze case studies where miniature XR technology could reduce the medical risks associated with spaceflight missions, specifically in diagnosing and managing conditions such as decompression sickness, traumatic shock, and EVA-related injuries.

A Anderson↗
DOE OSTI2021

MACCS Theory Manual

This report describes the models of the MACCS computer code as presented in MACCS Version 3.10.0. The purpose of MACCS is to simulate the impact of severe accidents at nuclear power plants on the surrounding environment. MACCS has been developed by Sandia National Laboratories for the U.S. Nuclear Regulatory Commission. From a given release of radioactive material into the atmosphere, MACCS estimates the extent and magnitude of radiological contamination, offsite doses, protective actions, socioeconomic impacts and costs, and health effects. Since the weather at the time of an accident is not predictable, MACCS supports various sampling options to run a representative set of simulations to evaluate weather variability. MACCS simulates atmospheric transport with a straight-line Gaussian plume segment model. From the estimated air and ground concentrations, MACCS models dose projections through several dose exposure pathways. These exposures can be offset by protective actions during the emergency response and long-term recovery of the accident. MACCS users directly specify the evacuation and sheltering area, while other protective actions (e.g., relocation, farmland restrictions, decontamination) are based on user-specified dose or concentration limits. While protective actions help reduce dose accumulation, they also cause social and economic impacts. MACCS models the extent of displaced individuals and land contamination, and the cost of offsite property damage, economic disruptions, and various accident expenditures caused by protective actions. Finally, from the dose accumulation, MACCS estimates early and stochastic health effects according to dose-response models. The purpose of consequence analyses is to be able to understand and estimate the impact of nuclear accidents. Consequence analysis is an essential tool to inform determinations of adequate protection of the public, to understand nuclear power hazards, to measure the value of regulations, and to help us appreciate the importance of nuclear safety. As such, MACCS has a variety of regulatory uses including environmental analyses (10 CFR 51.53, 52.47), regulatory cost-benefit analyses, backfit analyses (10 CFR 50.109), consequence analysis studies such as SOARCA (NUREG-1935), Level 3 PRA studies, and risk-informing of emergency planning (10 CFR 50 App. E and 50.47). This report updates the previous MACCS theory manual (NUREG/CR-4691 Vol. 2; Chanin, Sprung, Ritchie, & Jow, 1990) and accompanies the MACCS User's Guide (SAND-2021-1588) that describes the use and input requirements of the graphical user interface of MACCS known as WinMACCS. The MACCS User's Guide is also a reference guide that describes data input file formats, describes various software components in the MACCS code suite, and provides a set of example tutorials for running WinMACCS. Also, soon to be published is a MACCS input parameter guidance report (NUREG/CR-7270) that provides technical bases for commonly used MACCS input values. This page left blank

97 MATHEMATICS AND COMPUTING↗
NASA NTRSDate not supplied

Introduction to the IMPACT Probabilistic Risk and Tradespace Analysis Tool for Medical System Design

Background: Probabilistic risk analysis (PRA) is a method for estimating risk in complex engineered systems that, at a basic level, focuses on what can go wrong and the likelihood and consequences of those occurrences. NASA has used PRA as an integral component of medical system risk estimation and design for spaceflight. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a novel tool to meet these goals for exploration missions. Overview: IMPACT performs hundreds of thousands of Monte Carlo simulations of missions to build aggregate pictures of medical risk. These simulations are based on 120 possible medical conditions (the IMPACT Condition List) selected in a consensus-based process because they are of highest likelihood and/or consequence for exploration spaceflight. The conditions are then tied to clinical capabilities which can be used for management (e.g., inserting an IV) and then to over 600 specific resources needed to deliver a capability (e.g., an angiocath or an ultrasound). Different mission profiles can be simulated with user-specified inputs such as mission duration, destination, number of crew and pre-existing medical conditions, and EVA frequency. While the IMPACT evidence base is designed for exploration environments, these user inputs allow the tool to be used across a broad range of missions. IMPACT’s primary outcome metrics include loss of crew life (LOCL, a measure of in-flight mortality due to medical conditions), need for evacuation (RTDC, return to definitive care), and crew disability (TTL, task time lost based on how medical conditions impact the ability to perform over 1000 specific exploration mission crew tasks). In addition to modeling medical risk, IMPACT also accepts user-specified constraints, such as limitations of mass or volume, and will output a recommended clinical capability set and specific medical resources that meet the mission constraints. Discussion: This abstract will provide an introduction to IMPACT and describe the nature of the underlying medical evidence. It will also detail potential use cases for how this tool can be utilized by NASA or commercial spaceflight providers.

Ben Easter↗
NASA NTRS1990

Project EGRESS: Earthbound Guaranteed Reentry from Space Station. the Design of an Assured Crew Recovery Vehicle for the Space Station

Unlike previously designed space-based working environments, the shuttle orbiter servicing the space station will not remain docked the entire time the station is occupied. While an Apollo capsule was permanently available on Skylab, plans for Space Station Freedom call for a shuttle orbiter to be docked at the space station for no more than two weeks four times each year. Consideration of crew safety inspired the design of an Assured Crew Recovery Vehicle (ACRV). A conceptual design of an ACRV was developed. The system allows the escape of one or more crew members from Space Station Freedom in case of emergency. The design of the vehicle addresses propulsion, orbital operations, reentry, landing and recovery, power and communication, and life support. In light of recent modifications in space station design, Project EGRESS (Earthbound Guaranteed ReEntry from Space Station) pays particular attention to its impact on space station operations, interfaces and docking facilities, and maintenance needs. A water-landing medium-lift vehicle was found to best satisfy project goals of simplicity and cost efficiency without sacrificing safety and reliability requirements. One or more seriously injured crew members could be returned to an earth-based health facility with minimal pilot involvement. Since the craft is capable of returning up to five crew members, two such permanently docked vehicles would allow a full evacuation of the space station. The craft could be constructed entirely with available 1990 technology, and launched aboard a shuttle orbiter.

Source record↗
NASA NTRS2017

Systems Engineering for Space Exploration Medical Capabilities

Human exploration missions that reach destinations beyond low Earth orbit, such as Mars, will present significant new challenges to crew health management. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is applying systems engineering principles and practices to accomplish its goals. This paper discusses the structured and integrative approach that is guiding the medical system technical development. Assumptions for the required levels of care on exploration missions, medical system goals, and a Concept of Operations are early products that capture and clarify stakeholder expectations. Model-Based Systems Engineering techniques are then applied to define medical system behavior and architecture. Interfaces to other flight and ground systems, and within the medical system are identified and defined. Initial requirements and traceability are established, which sets the stage for identification of future technology development needs. An early approach for verification and validation, taking advantage of terrestrial and near-Earth exploration system analogs, is also defined to further guide system planning and development.

Mindock, Jennifer↗
NASA NTRS2017

Systems Engineering for Space Exploration Medical Capabilities

Human exploration missions to beyond low Earth orbit destinations such as Mars will present significant new challenges to crew health management during a mission compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is applying systems engineering principles and practices to accomplish its integrative goals. This paper discusses the structured and integrative approach that is guiding the medical system technical development. Assumptions for the required levels of care on exploration missions, medical system guiding principles, and a Concept of Operations are early products that capture and clarify stakeholder expectations. Mobel-Based Systems Engineering techniques are then applied to define medical system behavior and architecture. Interfaces to other flight and ground systems, and within the medical system are identified and defined. Initial requirements and traceability are established, which sets the stage for identification of future technology development needs. An early approach for verification and validation, taking advantage of terrestrial and near-Earth exploration system analogs, is also defined to further guide system planning and development.

Mindock, Jennifer↗
NASA NTRSDate not supplied

The Impact of Delayed Communication on NASA’s Human-Systems Operations: Preliminary Results of a Systematic Review

Throughout the history of human spaceflight, NASA has relied on a team of ground-based experts on Earth to manage its missions, vehicles, and crews to ensure crew safety and mission success. However, as missions progress beyond low-Earth orbit (LEO), this paradigm of dependence on ground must evolve. Beyond LEO, in missions to the moon and Mars, crews will confront new challenges: limited evacuation options, reduced resupply capabilities, and significant communication delays that impede real-time support from experts on the ground. This reduction in ground support amplifies the likelihood that crews will be unable to adequately respond to unanticipated, safety-critical events. Understanding the scope of these risks and identifying effective countermeasures hinges on understanding the impact of communication delays on complex operations, especially in urgent, unforeseen events. Real-time communication currently provides the crew with continuous access to a large, extensively resourced ground team skilled in anomaly resolution. However, as communication delays grow, the need to transfer some responsibilities from ground experts to onboard crew becomes evident. NASA has been exploring this shift in operational responsibilities and its effectiveness in managing complex operations for decades. Nevertheless, a comprehensive understanding of the specific challenges posed by communication delays and the necessary countermeasures to mitigate them remains a gap. In this paper, we present an update on our systematic review of the literature on communication delays, the first in-depth review since 2013 (Rader et al.). We introduce a coding taxonomy to capture key constructs from papers of interest and discuss preliminary findings. These preliminary results suggest two significant research gaps: limited studies have been conducted 1) with lunar-like latencies and 2) on problem-solving strategies for the maximum latencies expected in Mars missions. We outline plans and propose recommendations to address these gaps through ongoing and future research.

human-systems integration↗
NASA NTRSDate not supplied

The Impact of Delayed Communications on NASA's Human-Systems Operations: Preliminary Results of a Systematic Review

Throughout the history of human spaceflight, NASA has relied on a team of ground-based experts on Earth to manage its missions, vehicles, and crews to ensure crew safety and mission success. However, as missions progress beyond low-Earth orbit (LEO), this paradigm of dependence on ground must evolve. Beyond LEO, in missions to the moon and Mars, crews will confront new challenges: limited evacuation options, reduced resupply capabilities, and significant communication delays that impede real-time support from experts on the ground. This reduction in ground support amplifies the likelihood that crews will be unable to adequately respond to unanticipated, safety-critical events. Understanding the scope of these risks and identifying effective countermeasures hinges on understanding the impact of communication delays on complex operations, especially in urgent, unforeseen events. Real-time communication currently provides the crew with continuous access to a large, extensively resourced ground team skilled in anomaly resolution. However, as communication delays grow, the need to transfer some responsibilities from ground experts to onboard crew becomes evident. NASA has been exploring this shift in operational responsibilities and its effectiveness in managing complex operations for decades. Nevertheless, a comprehensive understanding of the specific challenges posed by communication delays and the necessary countermeasures to mitigate them remains a gap. In this paper, we present an update on our systematic review of the literature on communication delays, the first in-depth review since 2013 (Rader et al.). We introduce a coding taxonomy to capture key constructs from papers of interest and discuss preliminary findings. These preliminary results suggest two significant research gaps: limited studies have been conducted 1) with lunar-like latencies and 2) on problem-solving strategies for the maximum latencies expected in Mars missions. We outline plans and propose recommendations to address these gaps through ongoing and future research.

earth-independence↗
NASA NTRSDate not supplied

Supply and Resource Management to Progressively Enable EIMO

BACKGROUND: Current medical operations in Low Earth Orbit (LEO) allow for real-time audio-video communication with a flight surgeon at mission control, resupply, and medical evacuation to earth on the order of hours. As mission profiles change from LEO to the Moon, Mars, and beyond, medical risk as a contribution to overall mission risk is anticipated to rise substantially. Concurrently, due to the distance, the medical systems on board vehicles proposed for these mission types are expected to have reduced mass and volume allocation. Together, astronaut crews will be at a higher risk of major medical events, be required to perform a broader set of tasks, and have substantially reduced resources and support to do so. Earth Independent Medical Operations (EIMO) aims to identify and fill the gaps present in this progressively changing paradigm. OVERVIEW: Medical supplies, resources, and skills are central to spaceflight medical systems. Vehicles used for non-LEO missions are anticipated to be smaller and thus the medical system will also need to have reduced mass, volume, and power. Medical resources are another form of consumable and may need resupply or pre-deployment to meet crew needs. One particular concern is the degradation of medications which become less efficacious and potentially toxic with time, particularly given environmental conditions such as temperature, humidity, oxygen, and radiation which have not yet been fully studied. Supply and resource management in LEO is dependent on resupply, however the supply chain of transporting equipment does not yet have a clear infrastructure for missions beyond LEO. DISCUSSION: EIMO is intended to systemically identify and fill these gaps with forward-looking solutions. In mission monitoring of resources with technology like RFID, improving medical resource longevity, targeted resupply and careful pre-mission planning will be central to facilitate crew health and performance. One approach to optimizing resources is the Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) tool, which uses probabilistic risk assessment (PRA) to quantitatively predict medical risk and identify resources and skills that mitigate this risk. This evidence based, quantitative analysis prediction tool and several other approaches to meeting the challenge of supply and resource management are discussed.

Arian Anderson↗
NASA NTRS2025

Innovative Drug Selection, Storage, and Shelf-Life Strategies for Exploration Spaceflight

Medications have been a part of space travel dating back to the Apollo missions. A safe and effective medication formulary is essential to maintaining crew health and performance during long-duration spaceflight outside of low Earth orbit (LEO). Distance from Earth creates four key operational changes that increase medical risks, including communication, resupply, crewmember health, and evacuation. The current spaceflight pharmaceutical formulary consists of medications indicated to treat a variety of anticipated medical events and healthcare needs during spaceflight, but depends on a robust consumables resupply chain, which may be strained for a Lunar, and possibly non-existent for a Mars mission. The specific medications selections for the formulary may change to optimally align with the mission, crew compliment, and spacecraft design. Medical support at long-duration exploration missions will differ from LEO missions due to mission duration, lack of consumables resupply, prolonged exposure to space radiation, and the absence of emergency medical return capability. Loss of medication resupply limits or removes the ability to replace medications that have been exhausted or degraded, potentially exacerbating the medical risk posture. To address these anticipated risks, long-duration missions must consider use of novel medical technologies, treatment modalities, and smart medical systems that offer greater crew autonomy, such as physiologically based pharmacokinetic modeling, drug repurposing, on demand drug synthesis, or wearable drug delivery / monitoring devices. Once an ideal formulary for exploration space is determined, it is essential to establish the chemical and physical stability of each medication compound, as well as its safety by identifying its degradation profiles and products. Although few studies have been conducted to provide evidence on the physicochemical stability of pharmaceuticals during space missions, the data suggests that the spaceflight environment may promote degradation in some pharmaceuticals. Formulary drug purity and efficacy should be verified by pharmaceutical stability assessments, and can be realized non-destructively, and accessed in remote environments. Non-destructive pharmaceutical analysis and statistical modelling techniques could optimize exploration spaceflight medical care by enabling early detection of suboptimal therapeutics. Likewise, novel packaging, storage strategies, and dosage form innovations are promising countermeasures to optimize pharmaceutical shelf life, purity, and quality of exploration spaceflight medications. As we prepare for more distant exploration missions, risk management planning for astronaut healthcare should include the assembly of a medication formulary that is comprehensive enough to prevent or treat anticipated medical events, remains safe and chemically stable, and retains sufficient potency to last for the duration of the mission. Following extensive review of the literature, we will present innovative formulary optimization strategies, pharmaceutical stability assessment techniques, and storage and packaging solutions that could enhance drug safety and efficacy for future exploration spaceflight missions.

Vernie R Daniels↗
NASA NTRS2016

NASA Astronaut Urinary Conditions Associated with Spaceflight

INTRODUCTION: Spaceflight is associated with many factors which may promote kidney stone formation, urinary retention, and/or Urinary Tract Infection (UTI). According to ISS mission predictions supplied by NASA's Integrated Medical Model, kidney stone is the second and sepsis (urosepsis as primary driver) the third most likely reason for emergent medical evacuation from the International Space Station (ISS). METHODS: Inflight and postflight medical records of NASA astronauts were reviewed for urinary retention, UTI and kidney stones during Mercury, Gemini, Apollo, Mir, Shuttle, and ISS expeditions 1-38. RESULTS: NASA astronauts have had 7 cases of kidney stones in the 12 months after flight. Three of these cases occurred within 90 to 180 days after landing and one of the seven cases occurred in the first 90 days after flight. There have been a total of 16 cases (0.018 events per person-flights) of urinary retention during flight. The event rates per mission are nearly identical between Shuttle and ISS flights (0.019 vs 0.021 events per person-flights). In 12 of the 16 cases, astronauts had taken at least one space motion sickness medication. Upon further analysis, it was determined that the odds of developing urinary retention in spaceflight is 3 times higher among astronauts who took promethazine. The female to male odds ratio for inflight urinary retention is 11:14. An astronaut with urinary retention is 25 times more likely to have a UTI with a 17% infection rate per mission. There have been 9 reported UTIs during spaceflight. DISCUSSION: It is unclear if spaceflight carries an increased post-flight risk of kidney stones. Regarding urinary retention, the female to male odds ratio is higher during flight compared to the general population where older males comprise almost all cases due to prostatic hypertrophy. This female prevalence in spaceflight is even more concerning given the fact that there have been many more males in space than females. Terrestrial medications with a known side effect of urinary retention are also associated with urinary retention during flight. However, not all cases of urinary retention surrounded medication use inflight. It is also known that UTI is a terrestrial cause of urinary retention. Furthermore, the treatment of urinary retention with a urinary catheter may be more likely to initiate a UTI in space than on the ground, as aseptic techniques can be particularly challenging with an inexperienced provider in a free-floating environment. Inflight urinary retention and UTI have proven to be highly associated and urinary risks should be considered collectively when planning for space flight.

Law, Jennifer↗
NASA NTRS2025

Evaluating the Viability of Compact and Portable X-Ray Systems for an Exploration Medical System in a Ground Demonstration

MOTIVATION FOR INCLUDING X-RAY CAPABILITIES For upcoming exploration missions, the need for enhanced medical care becomes critical due to extended mission durations, significant communication delays, and minimal evacuation opportunities. Previous evidence by our team has revealed that among the 119 medical conditions targeted for management during spaceflight within NASA Exploration Medical Capability’s IMPACT Condition List, at least 36 could benefit from radiography (XR). Utilizing XR for diagnosis and management is hypothesized to significantly improve management of crew health by enabling the immediate evaluation and confirmation of potential injuries or illnesses. Beyond clinical applications, XR also holds potential for non-destructive testing (NDT). This includes applications such as assessing the structural integrity of the spacecraft, analyzing surface and meteorite samples, and inspecting onboard electronics. THREE CANDIDATE X-RAY SYSTEMS CHOSEN FOR GROUND DEMONSTRATION The Exploration Medical Capability Element (ExMC) and the Exploration Medical Integrated Product Team (XMIPT) of the Mars Campaign Office initiated early background work for ground demonstrations. In FY21, ExMC published a Concept of Operations to guide requirements development. By FY23, XMIPT and yet2, a technology scouting and open innovation consulting firm, had completed a market survey and trade study to identify potential miniature XR systems. Selection criteria included commercial-off-the-shelf availability, low mass and volume, and regulatory compliance. The top three candidate devices—Remedi REMEX-KA6, MinXray Impact, and FujiFilm Xair—were acquired to characterize the requirements and capabilities of each device. To facilitate testing, phantoms, and radiographic personal protective equipment (PPE) were purchased, and a dedicated space was designated for XRS usage at Glenn Research Center. During this presentation, the mass, volume, and power requirements for each of the three piloted devices are revealed, as well as information regarding the detector, mA, and kV of the devices. GOAL AND OBJECTIVES OF A MINI XRS GROUND DEMONSTRATION The primary goal of ExMC/XMIPT technology demonstrations is to bridge the gap in available, flight-ready medical device technology by flight-testing diagnostic and treatment technologies essential for managing medical conditions during exploration missions. These technologies must adhere to vehicle constraints such as mass, volume, power, and data requirements, integrate seamlessly with medical decision-support tools, and support increasingly Earth-independent operations. There are three main objectives for the future ground demonstration of these three devices. First, we aim to determine the full capabilities of these three miniature XR systems within the context of the spaceflight environment. While medical applications are the primary focus for the miniature XR, a comprehensive exploration of non-medical uses has been initiated by an XMIPT-sponsored NASA SPARK campaign to identify collaborators. Second, we plan to establish criteria and to use insights gained from evaluating each miniature XR against those criteria to select the most suitable system among the three candidates. Third, we intend to evaluate their suitability for flight certification, which includes assessing its durability for launch, reentry, and exposure to high background radiation, as well as its compatibility with existing data architecture systems. Numerous subject matter experts from NASA and partner institutions will support these objectives.

C A Haddix↗