Focused assessment with sonography for trauma in weightlessness: A feasibility study

Andrew W. Kirkpatrick, Douglas R. Hamilton, Savvas Nicolaou, Ashot E. Sargsyan, Mark R. Campbell, Alan Feiveson, Scott A. Dulchavsky, Shannon Melton, George Beck, David L Dawson

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

BACKGROUND: The Focused Assessment with Sonography for Trauma (FAST) examines for fluid in gravitationally dependent regions. There is no prior experience with this technique in weightlessness, such as on the International Space Station, where sonography is currently the only diagnostic imaging tool. STUDY DESIGN: A ground-based (1 g) porcine model for sonography was developed. We examined both the feasibility and the comparative performance of the FAST examination in parabolic flight. Sonographic detection and fluid behavior were evaluated in four animals during alternating weightlessness (0 g) and hypergravity (1.8 g) periods. During flight, boluses of fluid were incrementally introduced into the peritoneal cavity. Standardized sonographic windows were recorded. Postflight, the video recordings were divided into 169 20-second segments for subsequent interpretation by 12 blinded ultrasonography experts. Reviewers first decided whether a video segment was of sufficient diagnostic quality to analyze (determinate). Determinate segments were then analyzed as containing or not containing fluid. A probit regression model compared the probability of a positive fluid diagnosis to actual fluid levels (0 to 500 mL) under both 0-g and 1.8-g conditions. The in-flight sonographers found real-time scanning and interpretation technically similar to that of terrestrial conditions, as long as restraint was maintained. On blinded review, 80% of the recorded ultrasound segments were considered determinate. The best sensitivity for diagnosis in 0 g was found to be from the subhepatic space, with probability of a positive fluid diagnosis ranging from 9% (no fluid) to 51% (500 mL fluid). CONCLUSIONS: The FAST examination is technically feasible in weightlessness, and merits operational consideration for clinical contingencies in space.

Original languageEnglish (US)
Pages (from-to)833-844
Number of pages12
JournalJournal of the American College of Surgeons
Volume196
Issue number6
DOIs
StatePublished - Jun 1 2003
Externally publishedYes

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Weightlessness
Feasibility Studies
Ultrasonography
Wounds and Injuries
Hypergravity
Video Recording
Peritoneal Cavity
Diagnostic Imaging
Swine

ASJC Scopus subject areas

  • Surgery

Cite this

Focused assessment with sonography for trauma in weightlessness : A feasibility study. / Kirkpatrick, Andrew W.; Hamilton, Douglas R.; Nicolaou, Savvas; Sargsyan, Ashot E.; Campbell, Mark R.; Feiveson, Alan; Dulchavsky, Scott A.; Melton, Shannon; Beck, George; Dawson, David L.

In: Journal of the American College of Surgeons, Vol. 196, No. 6, 01.06.2003, p. 833-844.

Research output: Contribution to journalArticle

Kirkpatrick, AW, Hamilton, DR, Nicolaou, S, Sargsyan, AE, Campbell, MR, Feiveson, A, Dulchavsky, SA, Melton, S, Beck, G & Dawson, DL 2003, 'Focused assessment with sonography for trauma in weightlessness: A feasibility study', Journal of the American College of Surgeons, vol. 196, no. 6, pp. 833-844. https://doi.org/10.1016/S1072-7515(02)01906-3
Kirkpatrick AW, Hamilton DR, Nicolaou S, Sargsyan AE, Campbell MR, Feiveson A et al. Focused assessment with sonography for trauma in weightlessness: A feasibility study. Journal of the American College of Surgeons. 2003 Jun 1;196(6):833-844. https://doi.org/10.1016/S1072-7515(02)01906-3
Kirkpatrick, Andrew W. ; Hamilton, Douglas R. ; Nicolaou, Savvas ; Sargsyan, Ashot E. ; Campbell, Mark R. ; Feiveson, Alan ; Dulchavsky, Scott A. ; Melton, Shannon ; Beck, George ; Dawson, David L. / Focused assessment with sonography for trauma in weightlessness : A feasibility study. In: Journal of the American College of Surgeons. 2003 ; Vol. 196, No. 6. pp. 833-844.
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