Systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight.

Autor: Elias A; Cardiology and Vascular Medicine, Sainte Musse Hospital, Toulon Hospital Centre, Toulon, France. antoinelias@gmail.com.; Clinical Research and Innovation, Sainte Musse Hospital, Toulon Hospital Centre, Toulon, France. antoinelias@gmail.com.; Investigation Network On Venous Thrombo-Embolism | French Clinical Research Infrastructure Network (INNOVTE | F-CRIN), Toulon, France. antoinelias@gmail.com., Weber T; Space Medicine Team (HRE-OM), European Astronaut Center (EAC), European Space Agency (ESA), Cologne, Germany.; KBR, Cologne, Germany., Green DA; Space Medicine Team (HRE-OM), European Astronaut Center (EAC), European Space Agency (ESA), Cologne, Germany.; KBR, Cologne, Germany.; Centre of Human and Applied Physiological Sciences, King's College London, London, United Kingdom., Harris KM; Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada., Laws JM; University of Northumbria at Newcastle, Newcaslte-upon-Tyne, United Kingdom.; Space Biomedicine Systematic Review Methods Group, Wylam, United Kingdom., Greaves DK; Faculty of Health, University of Waterloo, Waterloo, ON, Canada., Kim DS; Space Medicine Team (HRE-OM), European Astronaut Center (EAC), European Space Agency (ESA), Cologne, Germany.; Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada., Mazzolai-Duchosal L; Department of Angiology, Lausanne University, Lausanne, Switzerland., Roberts L; King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, United Kingdom.; Institute of Pharmaceutical Sciences, King's College London, London, United Kingdom., Petersen LG; Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA, USA., Limper U; German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany.; University of Witten / Herdecke, Department of Anaesthesiology and Critical Care Medicine, Merheim Medical Center, Hospitals of Cologne, Cologne, Germany., Bergauer A; Department of Surgery, LKH Südsteiermark, Wagna, Austria.; Gravitational Physiology and Medicine Research Unit, Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria., Elias M; Critical Care Medicine, St. Vincent's Medical Center, Hartford Healthcare, Bridgeport, CT, USA.; The Frank H. Netter MD School of Medicine, North Haven, CT, USA., Winnard A; Space Biomedicine Systematic Review Methods Group, Wylam, United Kingdom., Goswami N; Division of Physiology, Otto Loewi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria.; Mohammed Bin Rashid University of Medicine and Applied Health Sciences, Dubai, United Arab Emirates.
Jazyk: angličtina
Zdroj: NPJ microgravity [NPJ Microgravity] 2024 Feb 05; Vol. 10 (1), pp. 14. Date of Electronic Publication: 2024 Feb 05.
DOI: 10.1038/s41526-024-00356-w
Abstrakt: The validity of venous ultrasound (V-US) for the diagnosis of deep vein thrombosis (DVT) during spaceflight is unknown and difficult to establish in diagnostic accuracy and diagnostic management studies in this context. We performed a systematic review of the use of V-US in the upper-body venous system in spaceflight to identify microgravity-related changes and the effect of venous interventions to reverse them, and to assess appropriateness of spaceflight V-US with terrestrial standards. An appropriateness tool was developed following expert panel discussions and review of terrestrial diagnostic studies, including criteria relevant to crew experience, in-flight equipment, assessment sites, ultrasound modalities, and DVT diagnosis. Microgravity-related findings reported as an increase in internal jugular vein (IJV) cross-sectional area and pressure were associated with reduced, stagnant, and retrograde flow. Changes were on average responsive to venous interventions using lower body negative pressure, Bracelets, Valsalva and Mueller manoeuvres, and contralateral IJV compression. In comparison with terrestrial standards, spaceflight V-US did not meet all appropriateness criteria. In DVT studies (n = 3), a single thrombosis was reported and only ultrasound modality criterion met the standards. In the other studies (n = 15), all the criteria were appropriate except crew experience criterion, which was appropriate in only four studies. Future practice and research should account for microgravity-related changes, evaluate individual effect of venous interventions, and adopt Earth-based V-US standards.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: