Sonographic Detection of Pneumothorax and Hemothorax in Microgravity

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

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Introduction: An intrathoracic injury may be disastrous to a crew-member aboard the International Space Station (ISS) if the diagnosis is missed or delayed. Symptomatic or clinically suspicious thoracic trauma is treated as a surgical emergency on Earth, usually with immediate stabilization and rapid transport to a facility that is able to deliver the appropriate medical care. A similar approach is planned for the ISS; however, an unnecessary evacuation would cause a significant mission impact and an exorbitant expense. Hypothesis: The use of ultrasound imaging for the detection of pneumothorax and hemothorax in microgravity is both possible and practical. Methods: Sonography was performed on anesthetized pigs in a ground-based laboratory (n = 4) and microgravity conditions (0 G) during parabolic flight (n = 4). Aliquots of air (50-500 ml) or saline (10-200 ml) were introduced into the pleural space to simulate pneumothorax and hemothorax, respectively. Results: The presence of "lung sliding" excluded pnemothorax. In microgravity, a loss of "lung sliding" was noted simultaneously in the anterior and posterior sonographic windows after 100 ml of air was introduced into the chest, indicating pneumothorax. The presence of the fluid layer in simulated hemothorax was noted in the anterior and posterior sonographic windows after 50 ml of fluid was injected into the pleural space. During the microgravity phase, the intrapleural fluid rapidly redistributed so that it could be detected using either anterior or posterior sonographic windows. Conclusion: Modest to severe pneumothorax and hemothorax can be diagnosed using ultrasound in microgravity.

Original languageEnglish (US)
Pages (from-to)272-277
Number of pages6
JournalAviation Space and Environmental Medicine
Volume75
Issue number3 SEC. I
StatePublished - Mar 2004

Fingerprint

Hemothorax
Weightlessness
Microgravity
Pneumothorax
Space stations
Fluids
Ultrasonography
Thorax
Ultrasonics
Air
Lung
Wounds and Injuries
Health care
Emergencies
Swine
Stabilization
Earth (planet)
Imaging techniques

Keywords

  • Chest tube
  • Hemothorax
  • Microgravity
  • Pneumothorax
  • Space medicine
  • Trauma
  • Ultrasound imaging

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Pollution
  • Medicine(all)

Cite this

Hamilton, D. R., Sargsyan, A. E., Kirkpatrick, A. W., Nicolaou, S., Campbell, M., Dawson, D. L., ... Dulchavsky, S. A. (2004). Sonographic Detection of Pneumothorax and Hemothorax in Microgravity. Aviation Space and Environmental Medicine, 75(3 SEC. I), 272-277.

Sonographic Detection of Pneumothorax and Hemothorax in Microgravity. / Hamilton, Douglas R.; Sargsyan, Ashot E.; Kirkpatrick, Andrew W.; Nicolaou, Savvas; Campbell, Mark; Dawson, David L; Melton, Shannon L.; Beck, George; Guess, Terry; Rasbury, Jack; Dulchavsky, Scott A.

In: Aviation Space and Environmental Medicine, Vol. 75, No. 3 SEC. I, 03.2004, p. 272-277.

Research output: Contribution to journalArticle

Hamilton, DR, Sargsyan, AE, Kirkpatrick, AW, Nicolaou, S, Campbell, M, Dawson, DL, Melton, SL, Beck, G, Guess, T, Rasbury, J & Dulchavsky, SA 2004, 'Sonographic Detection of Pneumothorax and Hemothorax in Microgravity', Aviation Space and Environmental Medicine, vol. 75, no. 3 SEC. I, pp. 272-277.
Hamilton DR, Sargsyan AE, Kirkpatrick AW, Nicolaou S, Campbell M, Dawson DL et al. Sonographic Detection of Pneumothorax and Hemothorax in Microgravity. Aviation Space and Environmental Medicine. 2004 Mar;75(3 SEC. I):272-277.
Hamilton, Douglas R. ; Sargsyan, Ashot E. ; Kirkpatrick, Andrew W. ; Nicolaou, Savvas ; Campbell, Mark ; Dawson, David L ; Melton, Shannon L. ; Beck, George ; Guess, Terry ; Rasbury, Jack ; Dulchavsky, Scott A. / Sonographic Detection of Pneumothorax and Hemothorax in Microgravity. In: Aviation Space and Environmental Medicine. 2004 ; Vol. 75, No. 3 SEC. I. pp. 272-277.
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AU - Dawson, David L

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N2 - Introduction: An intrathoracic injury may be disastrous to a crew-member aboard the International Space Station (ISS) if the diagnosis is missed or delayed. Symptomatic or clinically suspicious thoracic trauma is treated as a surgical emergency on Earth, usually with immediate stabilization and rapid transport to a facility that is able to deliver the appropriate medical care. A similar approach is planned for the ISS; however, an unnecessary evacuation would cause a significant mission impact and an exorbitant expense. Hypothesis: The use of ultrasound imaging for the detection of pneumothorax and hemothorax in microgravity is both possible and practical. Methods: Sonography was performed on anesthetized pigs in a ground-based laboratory (n = 4) and microgravity conditions (0 G) during parabolic flight (n = 4). Aliquots of air (50-500 ml) or saline (10-200 ml) were introduced into the pleural space to simulate pneumothorax and hemothorax, respectively. Results: The presence of "lung sliding" excluded pnemothorax. In microgravity, a loss of "lung sliding" was noted simultaneously in the anterior and posterior sonographic windows after 100 ml of air was introduced into the chest, indicating pneumothorax. The presence of the fluid layer in simulated hemothorax was noted in the anterior and posterior sonographic windows after 50 ml of fluid was injected into the pleural space. During the microgravity phase, the intrapleural fluid rapidly redistributed so that it could be detected using either anterior or posterior sonographic windows. Conclusion: Modest to severe pneumothorax and hemothorax can be diagnosed using ultrasound in microgravity.

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