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Elias A, Weber T, Green DA, Harris KM, Laws JM, Greaves DK, Kim DS, Mazzolai-Duchosal L, Roberts L, Petersen LG, Limper U, Bergauer A, Elias M, Winnard A, Goswami N. Systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight. NPJ Microgravity 2024; 10:14. [PMID: 38316814 PMCID: PMC10844233 DOI: 10.1038/s41526-024-00356-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 01/17/2024] [Indexed: 02/07/2024] Open
Abstract
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.
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Affiliation(s)
- Antoine Elias
- Cardiology and Vascular Medicine, Sainte Musse Hospital, Toulon Hospital Centre, Toulon, France.
- Clinical Research and Innovation, Sainte Musse Hospital, Toulon Hospital Centre, Toulon, France.
- Investigation Network On Venous Thrombo-Embolism | French Clinical Research Infrastructure Network (INNOVTE | F-CRIN), Toulon, France.
| | - Tobias Weber
- Space Medicine Team (HRE-OM), European Astronaut Center (EAC), European Space Agency (ESA), Cologne, Germany
- KBR, Cologne, Germany
| | - David A Green
- 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
| | - Katie M Harris
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Jonathan M Laws
- University of Northumbria at Newcastle, Newcaslte-upon-Tyne, United Kingdom
- Space Biomedicine Systematic Review Methods Group, Wylam, United Kingdom
| | | | - David S Kim
- 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
| | | | - Lara Roberts
- 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
| | - Lonnie G Petersen
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Ulrich Limper
- 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
| | - Andrej Bergauer
- 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
| | - Michael Elias
- 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
| | - Andrew Winnard
- Space Biomedicine Systematic Review Methods Group, Wylam, United Kingdom
| | - Nandu Goswami
- 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
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Adams SJ, Burbridge B, Obaid H, Stoneham G, Babyn P, Mendez I. Telerobotic Sonography for Remote Diagnostic Imaging: Narrative Review of Current Developments and Clinical Applications. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:1287-1306. [PMID: 33058242 DOI: 10.1002/jum.15525] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/08/2020] [Accepted: 09/12/2020] [Indexed: 05/23/2023]
Abstract
Access to sonographers and sonologists is limited in many communities around the world. Telerobotic sonography (robotic ultrasound) is a new technology to increase access to sonography, providing sonographers and sonologists the ability to manipulate an ultrasound probe from a distant location and remotely perform ultrasound examinations. This narrative review discusses the development of telerobotic ultrasound systems, clinical studies evaluating the feasibility and diagnostic accuracy of telerobotic sonography, and emerging use of telerobotic sonography in clinical settings. Telerobotic sonography provides an opportunity to provide real-time ultrasound examinations to underserviced rural and remote communities to increase equity in the delivery of diagnostic imaging.
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Affiliation(s)
- Scott J Adams
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Brent Burbridge
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Haron Obaid
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Grant Stoneham
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Paul Babyn
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ivar Mendez
- Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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