Validation of Ultrasound Imaging to Rule-out Thoracic Trauma on the International Space Station

Introduction: Aboard the International Space Station (ISS) an intra-thoracic injury may be disastrous to the crew member if the diagnosis is missed or even delayed. Pneumothorax and hemothorax commonly seen in trauma patients; the diagnosis is usually confirmed by chest X-ray or computed tomography. In this study, the ability of ultrasound to rule out pneumothorax by the presence "lung sliding" and hemothorax by the absence of pleural fluid was validated. Methods: The research activities were approved by the NASA Johnson Space Center Committee for the Protection of Human Subjects, and the participating crewmembers signed informed consent prior to the activity. ISS crewmembers received 2-hours of "hands on" ultrasound training 8 months prior to the on-orbit ultrasound exam. Baseline ultrasound images of the thorax were acquired on the crewmebers of Increment 8 and 9 prior to launch from Bakonur, Russia. Ultrasound examination of the thorax were performed on crewmembers at 30 day intervals (n=??) throughout their flight. Post flight images were acquired on or about landing day 10. Ultrasound images were acquired using the ISS Health Research Facility ultrasound system and examined by experts on the ground to rule out the presence of pneumothorax and hemothorax. Results: The presence of "lung sliding" which excludes pneumothorax, was seen in all subjects. The absence of pleural fluid, which excludes hemothorax was seen in all subjects. The optimal position between sonographer and patient under microgravity conditions and the amount and type of training for a non-physician crew medical officer for these procedures was also established for this procedure. Conclusion: Ultrasound can be performed on orbit under microgravity condition to rule thoracic trauma, such as pneumothorax and hemothorax.