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Graded Compression Stockings Prevent Post-spaceflight Orthostatic HypotensionPost-spaceflight orthostatic intolerance is characterized by hypotension and presyncope in 20-30% of returning astronauts. Previous data from our laboratory suggests that this is largely a result of decreased venous return. Currently, NASA astronauts wear an anti-gravity suit (AGS) which consists of inflatable air bladders over the calves, thighs and abdomen, which are typically pressurized from 0.5 to 1.5 PSI (~27 to 78 mmHg). ISS crew members sometimes wear Russian Kentavr suits which consist of laced compression shorts and gaiters, providing ~30 mmHg nominally. While these garments are effective during reentry, there are a number of drawbacks that make them impractical for postflight use. We studied the ability of commercially available, custom fit, graded compression stockings (Jobst, 55 mmHg at ankle to 6 mmHg at top of thigh, 25 mmHg mean compression) to prevent postflight orthostatic intolerance, hypothesizing that these garments would prevent orthostatic intolerance following short duration space flight. Crew members from a single Space Shuttle flight were tilted to 80 degrees for 10 min while wearing the stockings (n=5 males) upon arrival at the clinic (~2 hrs after landing). Hemodynamic data were compared to data from all crewmembers tilted (without countermeasures) since return to flight (n=9). Two-way, repeated measures ANOVA, using the entire tilt time curve (0-10 min) show that systolic blood pressure (SBP, group effect p=0.008), stroke volume (SV, group effect p=0.003), and cardiac output (CO, group effect p=0.004) were higher in crewmembers who wore the Jobst stockings. A one-way ANOVA comparing the last minute standing also showed that SV (p=0.001) and CO (p less than 0.001) were higher and SBP tended to be higher (p=0.06) in Jobst subjects compared to controls. Control subjects had a higher rate of presyncope than Jobst subjects (3/9 vs 0/5) during the tilt on landing day. Orthostatic hypotension continues to present following spaceflight, despite fluid loading and other countermeasures. This preliminary study shows that commercially available compression stockings may ameliorate this problem. These stockings are readily available, inexpensive, and can be worn for days following landing. We have observed similar protection against orthostatic intolerance in ground-based studies of hypovolemic test subjects. Further refinements to the design and compression of the stockings are in progress.
Document ID
20080043912
Acquisition Source
Johnson Space Center
Document Type
Conference Paper
Authors
Platts, S. H.
(NASA Johnson Space Center Houston, TX, United States)
Brown, A. K.
(MEI Technologies, Inc. Houston, TX, United States)
Locke, J.
(NASA Johnson Space Center Houston, TX, United States)
Stenger, M. B.
(Wyle Integrated Science and Engineering Group Houston, TX, United States)
Date Acquired
August 24, 2013
Publication Date
January 1, 2008
Subject Category
Aerospace Medicine
Meeting Information
Meeting: 56th Annual Meeting of the American Coll. of Sports Medicine
Location: Seattle, WA
Country: United States
Start Date: May 27, 2009
End Date: May 30, 2009
Sponsors: American Coll. of Sports Medicine
Distribution Limits
Public
Copyright
Other

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