Skip to main content Accessibility help
×
Home

Resuscitation and Evacuation from Low Earth Orbit: A Systematic Review

  • Craig D. Nowadly (a1) (a2), Brandon D. Trapp (a2), Stephen K. Robinson (a3) and John R. Richards (a2)

Abstract

Introduction:

Provision of critical care and resuscitation was not practical during early missions into space. Given likely advancements in commercial spaceflight and increased human presence in low Earth orbit (LEO) in the coming decades, development of these capabilities should be considered as the likelihood of emergent medical evacuation increases.

Methods:

PubMed, Web of Science, Google Scholar, National Aeronautics and Space Administration (NASA) Technical Server, and Defense Technical Information Center were searched from inception to December 2018. Articles specifically addressing critical care and resuscitation during emergency medical evacuation from LEO were selected. Evidence was graded using Oxford Centre for Evidence-Based Medicine guidelines.

Results:

The search resulted in 109 articles included in the review with a total of 2,177 subjects. There were two Level I systematic reviews, 33 Level II prospective studies with 647 subjects, seven Level III retrospective studies with 1,455 subjects, and two Level IV case series with four subjects. There were two Level V case reports and 63 pertinent review articles.

Discussion:

The development of a medical evacuation capability is an important consideration for future missions. This review revealed potential hurdles in the design of a dedicated LEO evacuation spacecraft. The ability to provide critical care and resuscitation during transport is likely to be limited by mass, volume, cost, and re-entry forces. Stabilization and treatment of the patient should be performed prior to departure, if possible, and emphasis should be on a rapid and safe return to Earth for definitive care.

Copyright

Corresponding author

Correspondence: Craig D. Nowadly, MD Department of Emergency Medicine PSSB 2100, U.C. Davis Medical Center 4150 V Street Sacramento, California 95817 USA E-mail: cdnowadly@ucdavis.edu

References

Hide All
1. Barratt, MR, Pool, SL, (eds). Principles of Clinical Medicine for Space Flight. New York, USA: Springer; 2008
2. Moher, D, Shamseer, L, Clarke, M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;1(4):1.
3. Oxford Centre for Evidence-Based Medicine. 2011 Levels of Evidence. http://www.cebm.net/index.aspx?o=5653. Published 2011. Accessed July 25, 2019.
4. Braunecker, S, Douglas, B, Hinkelbein, J. Comparison of different techniques for in microgravity-a simple mathematic estimation of cardiopulmonary resuscitation quality for space environment. Am J Emerg Med. 2015;33(7):920924.
5. Komorowski, M, Fleming, S, Mawkin, M, Hinkelbein, J. Anesthesia in austere environments: literature review and considerations for future space exploration missions. NPJ Microgravity. 2018;4:5.
6. Billica, R, Gosbee, J, Krupa, D. Evaluation of cardiopulmonary resuscitation techniques in microgravity. https://ntrs.nasa.gov/search.jsp?R=19910023475. Published 1991. Accessed July 25, 2019.
7. Billica, R, Young, J, Rushing, D, Kizzee, V. Fluid handling 2: surgical applications. http://hdl.handle.net/2060/19910023476. Published 1991. Accessed July 25, 2019.
8. Gosbee, J, Kupra, D, Pepper, L, Orsak, D. ATLS: Catheter and tube placement. https://ntrs.nasa.gov/search.jsp?R=19910023468. Published 1991. Accessed July 25, 2019.
9. Maidlow, K, Schulz, J, Lloyd, C, Breeding, T. Shuttle Orbiter medical system equipment/supplies evaluation. https://ntrs.nasa.gov/search.jsp?R=19910023479. Published 1991. Accessed July 25, 2019.
10. McCuaig, KE, Houtchens, BA. Management of trauma and emergency surgery in space. J Trauma. 1992;33(4):610625.
11. Campbell, MR, Billica, RD, Johnston, SL. Surgical bleeding in microgravity. Surg Gynecol Obstet. 1993;177(2):121125.
12. Guy, HJ, Prisk, GK, Elliott, AR, Deutschman, RA, West, JB. Inhomogeneity of pulmonary ventilation during sustained microgravity as determined by single-breath washouts. J Appl Physiol. 1994;76(4):17191729.
13. Prisk, GK, Guy, HJ, Elliott, AR, West, JB. Inhomogeneity of pulmonary perfusion during sustained microgravity on SLS-1. J Appl Physiol. 1994;76(4):17301738.
14. Leach, CS, Alfrey, CP, Suki, WN, et al. Regulation of body fluid compartments during short-term spaceflight. J Appl Physiol. 1996;81(1):105116.
15. Harris, BA, Billica, RD, Bishop, SL, et al. Physical examination during space flight. Mayo Clin Proc. 1997;72(4):301308.
16. Cuttino, CM. Martian emergency medical crisis management. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.664.3137&rep=rep1&type=pdf. Published 1999. Accessed July 25, 2019.
17. Keller, C, Brimacombe, J, A FR, et al. Airway management during spaceflight: a comparison of four airway devices in simulated microgravity. Anesthesiol. 2000;92(5):12371241.
18. Campbell, MR, Billica, RD, Johnston, SL, Muller, MS. Performance of advanced trauma life support procedures in microgravity. Aviat Space Environ Med. 2002;73(9):907912.
19. Jay, GD, Lee, P, Goldsmith, H, Battat, J, Maurer, J, Suner, S. CPR effectiveness in microgravity: comparison of three positions and a mechanical device. Aviat Space Environ Med. 2003;74(11):11831189.
20. Johnston, SL, Campbell, MR, Billica, RD, Gilmore, SM. Cardiopulmonary resuscitation in microgravity: efficacy in the swine during parabolic flight. Aviat Space Environ Med. 2004;75(6):546550.
21. Spaulding, J, Gaukler, E, Syracuse, E, Brodsky, L, Shean, D. Assessment of intravenous fluid delivery systems for a microgravity environment. http://arc.aiaa.org/doi/10.2514/6.IAC-04-G.2.11. Published 2004. Accessed July 25, 2019.
22. Evetts, SN, Evetts, LM, Russomano, T, Castro, JC, Ernsting, J. Basic life support in microgravity: evaluation of a novel method during parabolic flight. Aviat Space Environ Med. 2005;76(5):506510.
23. Groemer, GE, Brimacombe, J, Haas, T, et al. The feasibility of laryngoscope-guided tracheal intubation in microgravity during parabolic flight: a comparison of two techniques. Anesth Analg. 2005;101(5):15331535.
24. Rabitsch, W, Moser, D, Inzunza, MR, et al. Airway management with endotracheal tube versus Combitube during parabolic flights. Anesthesiol. 2006;105(4):696702.
25. Stepaniak, PC, Hamilton, GC, Olson, JE, Gilmore, SM, Stizza, DM, Beck, B. Physiologic effects of simulated + Gx orbital reentry in primate models of hemorrhagic shock. Aviat Space Environ Med. 2007;78(4 Suppl):A1425.
26. Barnes, SL, Branson, R, Gallo, LA, Beck, G, Johannigman, JA. En-route care in the air: snapshot of mechanical ventilation at 37,000 feet. J Trauma. 2008;64 (2 Suppl):S129135.
27. Mathers, CH. Measurement of accelerations experienced by rough stock riders: a model for examining acceleration-induced head injuries in astronauts. https://utmb-ir.tdl.org/utmb-ir/handle/2152.3/146. Published 2009. Accessed July 25, 2019.
28. Hurst, VW, Whittam, SW, Austin, PN, Branson, RD, Beck, G. Cardiopulmonary resuscitation during spaceflight: examining the role of timing devices. Aviat Space Environ Med. 2011;82(8):810813.
29. Kordi, M, Cardoso, RB, Russomano, T. A preliminary comparison between methods of performing external chest compressions during microgravity simulation. Aviat Space Environ Med. 2011;82(12):11611163.
30. Rehnberg, L, Ashcroft, A, Baers, JH, et al. Three methods of manual external chest compressions during microgravity simulation. Aviat Space Environ Med. 2014;85(7):687693.
31. McQuillen, J, McKay, T, Griffin, D, Brown, D, Zoldak, J. Final report for intravenous fluid generation (IVGEN) spaceflight experiment. https://ntrs.nasa.gov/search.jsp?R=20110014585. Published 2011. Accessed July 25, 2019.
32. Blue, RS, Riccitello, JM, Tizard, J, Hamilton, RJ, Vanderploeg, JM. Commercial spaceflight participant G-force tolerance during centrifuge-simulated suborbital flight. Aviat Space Environ Med. 2012;83(10):929934.
33. Russomano, T, Baers, JH, Velho, R, et al. A comparison between the 2010 and 2005 basic life support guidelines during simulated hypo-gravity and microgravity. Extrem Physiol Med. 2013;2:11.
34. Blue, RS, Pattarini, JM, Reyes, DP, et al. Tolerance of centrifuge-simulated suborbital spaceflight by medical condition. Aviat Space Environ Med. 2014;85(7):721729.
35. Rehnberg, L, Russomano, T, Falcão, F, Campos, F, Everts, SN. Evaluation of a novel basic life support method in simulated microgravity. Aviat Space Environ Med. 2011;82(2):104110.
36. Komorowski, M, Fleming, S. Intubation after rapid sequence induction performed by non-medical personnel during space exploration missions: a simulation pilot study in a Mars analogue environment. Extreme Physiol Med. 2015;4:19.
37. Reschke, MF, Good, EF, Clément, GR. Neurovestibular symptoms in astronauts immediately after Space Shuttle and International Space Station missions. OTO Open. 2017;1(4):2473974X1773876.
38. Suresh, R, Blue, RS, Mathers, CH, Castleberry, TL, Vanderploeg, JM. Dysrhythmias in laypersons during centrifuge-simulated suborbital spaceflight. Aerosp Med Hum Perform. 2017;88(11):10081015.
39. Bacal, K, Billica, R, Bishop, S. Neurovestibular symptoms following space flight. J Vestib Res. 2003;13(2–3):93102.
40. Gontcharov, IB, Kovachevich, IV, Pool, SL, et al. In-flight medical incidents in the NASA-Mir program. Aviat Space Environ Med. 2005;76(7):692696.
41. Johannigman, J, Gerlach, T, Cox, D, et al. Hypoxemia during aeromedical evacuation of the walking wounded. J Trauma Acute Care Surg. 2015;79(4 Suppl 2):S216220.
42. Keenan, A, Young, M, Saile, L, et al. The Integrated Medical Model: a probabilistic simulation model predicting in-flight medical risks. https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20150018879.pdf. Published 2015. Accessed July 25, 2019.
43. Menon, AS, Jourdan, D, Nusbaum, DM, et al. Crew recovery and contingency planning for a manned stratospheric balloon flight – the StratEx program. Prehosp Disaster Med. 2016;31(5):524531.
44. Maddry, JK, Mora, AG, Savell, SC, et al. Impact of Critical Care Air Transport Team (CCATT) ventilator management on combat mortality. J Trauma Acute Care Surg. 2018;84(1):157164.
45. Myers, J, Garcia, Y, Griffin, D, et al. The Integrated Medical Model: outcomes from independent review. https://ntrs.nasa.gov/search.jsp?R=20170004392. Published 2017. Accessed July 25, 2019.
46. Blue, RS, Reyes, DP, Castleberry, TL, Vanderploeg, JM. Centrifuge-simulated suborbital spaceflight in subjects with cardiac implanted devices. Aerosp Med Hum Perform. 2015;86(4):410413.
47. Levin, DR, Blue, RS, Castleberry, TL, Vanderploeg, JM. Tolerance of centrifuge-simulated suborbital spaceflight in subjects with implanted insulin pumps. Aerosp Med Hum Perform. 2015;86(4):407409.
48. Blue, RS, Blacher, E, Castleberry, TL, Vanderploeg, JM. Centrifuge-simulated suborbital spaceflight in a subject with cardiac malformation. Aerosp Med Hum Perform. 2015;86(11):9991003.
49. Suresh, R, Blue, RS, Mathers, C, Castleberry, TL, Vanderploeg, JM. Sustained accelerated idioventricular rhythm in a centrifuge-simulated suborbital spaceflight. Aerosp Med Hum Perform. 2017;88(8):789793.
50. Seeler, H. Complete emergency life sustaining system for spacecraft. Aerospace Med. 1964;35:3740.
51. Hinton, MG. Space rescue operations. http://hdl.handle.net/2060/19710025596. Published 1971. Accessed July 25, 2019.
52. Perchonok, E. Advanced missions’ safety. Volume 2: Technical discussion. Part 1: Space Shuttle rescue capability. https://ntrs.nasa.gov/search.jsp?R=19730003145. Published 1972. Accessed July 25, 2019.
53. LeJeune, FE. Laryngoscopy in space travel. Ann Otol Rhinol Laryngol. 1979;88(Pt 1):813817.
54. Frey, R, Dürner, P, Von Baumgarten, R, Vogel, H. Emergency medical care on space stations. Acta Astronaut. 1980;7(12):14831484.
55. Griswold, HR, Trusch, RB. Emergency and rescue considerations for manned space missions. Acta Astronaut. 1981;8(9–10):11231133.
56. Stazhadze, LL, Goncharov, IB, Neumyvakin, IP, Bogomolov, VV, Vladimirov, IV. Anesthesia, surgical aid and resuscitation in manned space missions. Acta Astronaut. 1981;8(9–10):11091113.
57. Houtchens, B. System for the management of trauma and emergency surgery in space. https://ntrs.nasa.gov/search.jsp?R=19840012977. Published 1984. Accessed July 25, 2019.
58. Kelly, BK. A systems analysis of emergency escape and recovery systems for the US Space Station. http://www.dtic.mil/docs/citations/ADA179233. Published 1986. Accessed July 25, 2019.
59. Halsell, JD, Widhalm, JW, Whitsett, CE. Design of an interim space rescue ferry vehicle. J Spacecraft Rocket. 1988;25:180186.
60. Naftel, J, Powell, R, Talay, T. Ascent, abort, and entry capability assessment of a Space Station rescue and personnel/logistics vehicle. http://arc.aiaa.org/doi/10.2514/6.1989-635. Published 1989. Accessed July 25, 2019.
61. National Aeronautics and Space Administration (NASA). Preliminary subsystem designs for the Assured Crew Return Vehicle (ACRV). http://hdl.handle.net/2060/19900016723. Published 1990. Accessed July 25, 2019.
62. Cerimele, CJ. Assured Crew Return Vehicle. https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/19900014139.pdf. Published 1991. Accessed July 25, 2019.
63. Nicogossian, AE, Rummel, JD, Leveton, L, Teeter, R. Development of countermeasures for medical problems encountered in space flight. Adv Space Res. 1992;12(1):329337.
64. Campbell, MR, Billica, RD. A review of microgravity surgical investigations. Aviat Space Environ Med. 1992;63(6):524528.
65. Chandler, MR. Space Station Freedom Assured Crew Return Vehicle medical issues. http://papers.sae.org/921143. Published 1992. Accessed July 25, 2019.
66. Dons, RF, Fohlmeister, U. Combined injury syndrome in space-related radiation environments. Adv Space Res. 1992;12(2–3):157163.
67. Siegel, JH. Medical and surgical evaluation and care of illness in space. https://ntrs.nasa.gov/search.jsp?R=19950004524. Published 1994. Accessed July 25, 2019.
68. McCuaig, K. Surgical problems in space: an overview. J Clin Pharmacol. 1994;34(5):513517.
69. Mazanek, DD, Garn, M, Troutman, P, Wang, Y, Kumar, R, Heck, M. International Space Station (ISS) accommodation of a single US Assured Crew Return Vehicle (ACRV). https://ntrs.nasa.gov/search.jsp?R=19980007312. Published 1997. Accessed July 25, 2019.
70. Smith, SM, Krauhs, JM, Leach, CS. Regulation of body fluid volume and electrolyte concentrations in spaceflight. Adv Space Biol Med. 1997;6:123165.
71. Wilson, JR. CRV investment offers safe return. Aerosp Am. 1997;35(6):2832;38.
72. National Aeronautics and Space Administration (NASA). The Space Shuttle Extravehicular Mobility Unit (EMU). https://www.nasa.gov/pdf/188963main_Extravehicular_Mobility_Unit.pdf. Published 1998. Accessed July 25, 2019.
73. Norfleet, WT. Anesthetic concerns of spaceflight. Anesthesiol. 2000;92(5):12191222.
74. Stepaniak, P, Hamilton, GC, Stizza, D, Garrison, R, Gerstner, D. Considerations for medical transport from the Space Station via an Assured Crew Return Vehicle (ACRV). =https://ntrs.nasa.gov/search.jsp?R=20010073453. Published 2001. Accessed July 25, 2019.
75. Agnew, JW, Fibuch, EE, Hubbard, JD. Anesthesia during and after exposure to microgravity. Aviat Space Environ Med. 2004;75(7):571580.
76. Bacal, K, Beck, G, McSwain, NE. A concept of operations for contingency medical care on the International Space Station. Mil Med. 2004;169(8):631641.
77. Beck, G. Emergency airway management in orbit: an evidence-based review of possibilities. Respiratory Care Clinics. 2004;10(3):401421.
78. Kaczka, D, Beck, G. Mechanical ventilation in orbit: emphasis on closed-loop ventilation. Resp Care Clin. 2004;10(3):369400.
79. Cooke, WH, Convertino, VA. Cardiovascular consequences of weightlessness promote advances in clinical and trauma care. Curr Pharm Biotechnol. 2005;6(4):285297.
80. Summers, RL, Johnston, SL, Marshburn, TH, Williams, DR. Emergencies in space. Ann Emerg Med. 2005;46(2):177184.
81. Convertino, VA, Ryan, KL. Identifying physiological measurements for medical monitoring: implications for autonomous health care in austere environments. J Gravit Physiol. 2007;14(1):P3942.
82. Miller, F, Niederhaus, C, Barlow, K, Griffin, D. Intravenous solutions for exploration missions. http://arc.aiaa.org/doi/10.2514/6.2007-544. Published 2007. Accessed July 25, 2019.
83. Muratore, JF. Space rescue. https://ntrs.nasa.gov/search.jsp?R=20070025530. Published 2007; Accessed July 25, 2019.
84. Roan, RM, Boyd, GL. Prediction of a low success rate of astronauts in space in performing endotracheal intubation. Anesthesiol. 2007;106(6):12471248.
85. Stewart, LH, Trunkey, D, Rebagliati, GS. Emergency medicine in space. J Emerg Med. 2007;32(1):4554.
86. Hamilton, D, Smart, K, Melton, S, Polk, JD, Johnson-Throop, K. Autonomous medical care for exploration class space missions. J Trauma. 2008;64(4 Suppl):S354363.
87. Hatfield, T. Lightweight trauma module – LTM. https://ntrs.nasa.gov/search.jsp?R=20080012521. Published 2008. Accessed July 25, 2019.
88. Smith, LJ, Arenare, BA, Smart, KT. Medical evacuation and vehicles for transport. In: Barratt, MR, Pool, SL (eds). Principles of Clinical Medicine for Space Flight. New York USA: Springer; 2008:139162.
89. Kirkpatrick, AW, Ball, CG, Campbell, M, et al. Severe traumatic injury during long duration spaceflight: light years beyond ATLS. J Trauma Manag Outcomes. 2009;3:4.
90. Minard, CG, Freire de Carvalho, M, Iyengar, MS. Optimizing medical kits for space flight. https://ntrs.nasa.gov/search.jsp?R=20100031230. Published 2010. Accessed July 25, 2019.
91. Haidegger, T, Sándor, J, Benyó, Z. Surgery in space: the future of robotic telesurgery. Surg Endosc. 2011;25(3):681690.
92. National Aeronautics and Space Administration (NASA). CHeCS (Crew Health Care Systems): International Space Station (ISS) medical hardware catalog. Version 10.0. https://ntrs.nasa.gov/search.jsp?R=20110022379. Published 2011. Accessed July 25, 2019.
93. Stewart, GE, Drudi, L. Medical education for exploration class missions: NASA aerospace medicine elective at the Kennedy Space Centre. Mcgill J Med. 2011;13(2):55.
94. Drudi, L, Ball, CG, Kirkpatrick, AW, Saary, J, Grenon, SM. Surgery in space: where are we at now? Acta Astronaut. 2012;79:6166.
95. Hinkelbein, J, Schwalbe, M, Dambier, M, Spelten, O, Wetsch, W, Neuhaus, C. Current concepts for anesthesia and emergency medicine in space. Resuscitation. 2012;83(3):e7980.
96. Law, J, Vanderploeg, J. An emergency medical planning guide for commercial spaceflight events. Aviat Space Environ Med. 2012;83(9):890895.
97. National Aeronautics and Space Administration (NASA). Ventilator technologies sustain critically injured patients. http://hdl.handle.net/2060/20120001890. Published 2011. Accessed July 25, 2019.
98. Komorowski, M, Watkins, SD, Lebuffe, G, Clark, JB. Potential anesthesia protocols for space exploration missions. Aviat Space Environ Med. 2013;84(3):226233.
99. Kuypers, MI. Emergency and wilderness medicine training for physician astronauts on exploration class missions. Wilderness Environ Med. 2013;24(4):445449.
100. McQuillen, J. Design constraints regarding the use of fluids in emergency medical systems for space flight. https://ntrs.nasa.gov/search.jsp?R=20140003970. Published 2013. Accessed July 25, 2019.
101. Keenan, A, Foy, M, Myers, J. Mass and volume optimization of space flight medical kits. https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20140008662.pdf. Published 2014. Accessed July 25, 2019.
102. Kirkpatrick, A, LaPorta, A, Brien, S, et al. Technical innovations that may facilitate real-time tele-mentoring of damage control surgery in austere environments: a proof of concept comparative evaluation of the importance of surgical experience, telepresence, gravity and mentoring in the conduct of damage control laparotomies. Can J Surgery. 2015;58(3 Suppl 3):S8890.
103. Alexander, D. Trauma and surgical capabilities for space exploration. In: Gillman, LM, Widder, S, Blaivas, M, Karakitsos, D (eds). Trauma Team Dynamics. Berlin, Germany: Springer; 2016:253266.
104. Garbino, A, Nusbaum, DM, Buckland, DM, Menon, AS, Clark, JB, Antonsen, EL. Emergency medical considerations in a space-suited patient. Aerosp Med Hum Perform. 2016;87(11):958962.
105. Komorowski, M, Fleming, S, Hinkelbein, J. Anesthesia in outer space: the ultimate ambulatory setting? Curr Opin Anaesthesiol. 2016;29(6):649654.
106. Komorowski, M, Fleming, S, Kirkpatrick, AW. Fundamentals of anesthesiology for spaceflight. J Cardiothorac Vasc Anesth. 2016;30(3):781790.
107. National Aeronautics and Space Administration (NASA). Emergency medical procedures manual for the International Space Station (ISS). http://www.governmentattic.org/19docs/NASA-ISSmedicalEmergManual_2016.pdf. Published 2016. Accessed July 25, 2019.
108. Halberg, EE, Robinson, S, Onishi, R, Blaesser, N. An ISS space ambulance based on X-37B technology. http://arc.aiaa.org/doi/10.2514/6.2016-5476. Published 2016. Accessed July 25, 2019.
109. Hodkinson, PD, Anderton, RA, Posselt, BN, Fong, KJ. An overview of space medicine. Br J Anaesth. 2017;119(Suppl 1):i143i153.
110. Kirkpatrick, AW, McKee, JL, Tien, H, et al. Damage control surgery in weightlessness: a comparative study of simulated torso hemorrhage control comparing terrestrial and weightless conditions. J Trauma Acute Care Surg. 2017;82(2):392399.
111. Cheatham, ML. Advanced Trauma Life Support for the injured astronaut. http://www.surgicalcriticalcare.net/Resources/ATLS_astronaut.pdf. Accessed July 25, 2019.
112. Hinkelbein, J, Russomano, T, Hinkelbein, F, Komorowski, M. Cardiac arrest during space missions: specificities and challenges. Trend Anaesth Crit Care. 2018;19(4):612.
113. Hailey, M, Urbina, M, Hughlett, J, et al. Evaluating the medical kit system for the International Space Station (ISS) – a paradigm revisited. https://ntrs.nasa.gov/search.jsp?=20100036577. Published 2010. Accessed July 25, 2019.
114. United States US Pharmacopeia. Pharmaceutical compounding—nonsterile preparations. http://www.usp.org/sites/default/files/usp/document/our-work/compounding/usp-gc-795-proposed-revision.pdf. Accessed July 25, 2019.
115. Davis, JR. Fundamentals of aerospace medicine. https://nls.ldls.org.uk/welcome.html?ark:/81055/vdc_100031348710.0x000001. Published 2011. Accessed July 25, 2019.
116. Gibbs, Y. NASA Armstrong Fact Sheet: X-38 Prototype Crew Return Vehicle. NASA. http://www.nasa.gov/centers/armstrong/news/FactSheets/FS-038-DFRC.html. Published 2014. Accessed July 25, 2019.
117. Wright, J. Russian Soyuz TMA Spacecraft Details. NASA. http://www.nasa.gov/mission_pages/station/structure/elements/soyuz/spacecraft_detail.html. Published 2015. July 25, 2019.
118. Britton, T, Blakeman, TC, Eggert, J, Rodriquez, D, Ortiz, H, Branson, RD. Managing endotracheal tube cuff pressure at altitude: a comparison of four methods. J Trauma Acute Care Surg. 2014;77(3 Suppl 2):S240244.
119. Pomprapa, A, Muanghong, D, Köny, M, et al. Artificial intelligence for closed-loop ventilation therapy with hemodynamic control using the open lung concept. Int J Intelligent Comput Cybernetics. 2015;8(1):5068.
120. Gates, S, Quinn, T, Deakin, CD, Blair, L, Couper, K, Perkins, GD. Mechanical chest compression for out of hospital cardiac arrest: systematic review and meta-analysis. Resuscitation. 2015;94:9197.
121. Electronic Medicines Compendium. Ketamine summary of product characteristics. https://www.medicines.org.uk/emc/product/2420/smpc#SHELF_LIFE. Published 2016. Accessed July 25, 2019.
122. Guldner, GT, Petinaux, B, Clemens, P, Foster, S, Antoine, S. Ketamine for procedural sedation and analgesia by non-anesthesiologists in the field: a review for military health care providers. Mil Med. 2006;171(6):484490.
123. Kurdi, M, Theerth, K, Deva, R. Ketamine: current applications in anesthesia, pain, and critical care. Anesth Essays Res. 2014;8(3):283.
124. NASA Johnson Space Center. Non-invasive and unobtrusive blood pressure measurement: 2018 Wearable Technologies Workshop Challenge Request. https://techcollaboration.center/wp-content/uploads/Workshops/WearableTechnologies/Challenges/TCC_WT_Challenge-NASAJSC-Non-Invasive-and-Unobtrusive-Blood-Pressure-Measurement.pdf. Published 2018. Accessed July 25, 2019.

Keywords

Type Description Title
WORD
Supplementary materials

Nowadly et al. supplementary material
Table S1

 Word (36 KB)
36 KB

Resuscitation and Evacuation from Low Earth Orbit: A Systematic Review

  • Craig D. Nowadly (a1) (a2), Brandon D. Trapp (a2), Stephen K. Robinson (a3) and John R. Richards (a2)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed