Utility of ultrasound in managing acute medical conditions in space: a scoping review

Parsa Asachi; Ghadi Ghanem; Jason Burton; Haig Aintablian; Alan Chiem

doi:10.1186/s13089-023-00349-y

Utility of ultrasound in managing acute medical conditions in space: a scoping review

Ultrasound J. 2023 Dec 12;15(1):47. doi: 10.1186/s13089-023-00349-y.

Authors

Parsa Asachi¹, Ghadi Ghanem², Jason Burton³, Haig Aintablian⁴, Alan Chiem⁵

Affiliations

¹ David Geffen School of Medicine at UCLA, 855 Tiverton Dr, Los Angeles, CA, 90024, USA. parsaasachi@g.ucla.edu.
² David Geffen School of Medicine at UCLA, 855 Tiverton Dr, Los Angeles, CA, 90024, USA.
³ University of California, Los Angeles Library, Los Angeles, CA, USA.
⁴ Department of Emergency Medicine, David Geffen School of Medicine UCLA, Los Angeles, CA, USA.
⁵ Department of Emergency Medicine, David Geffen School of Medicine UCLA, Olive View UCLA Medical Center, Los Angeles, CA, USA.

Abstract

Background: In long-distance spaceflight, the challenges of communication delays and the impracticality of rapid evacuation necessitate the management of medical emergencies by onboard physicians. Consequently, these physicians must be proficient in tools, such as ultrasound, which has proven itself a strong diagnostic imaging tool in space. Yet, there remains a notable gap in the discourse surrounding its efficacy in handling acute medical scenarios. This scoping review aims to present an updated analysis of the evidence supporting the role of ultrasound in diagnosing acute conditions within microgravity environments.

Methods: A systematic search was executed across three bibliographic databases: PubMed, EMBASE (Embase.com), and the Web of Science Core Collection. We considered articles published up to February 25, 2023, that highlighted the application of ultrasound in diagnosing acute medical conditions in either microgravity or microgravity-simulated settings. Exclusions were made for review papers, abstracts, and in-vitro studies.

Results: After removing duplicates, and filtering papers by pre-determined criteria, a total of 15 articles were identified that discuss the potential use of ultrasound in managing acute medical conditions in space. The publication date of these studies ranged from 1999 to 2020. A relatively similar proportion of these studies were conducted either on the International Space Station or in parabolic flight, with one performed in supine positioning to simulate weightlessness. The included studies discuss acute pathologies, such as abdominal emergencies, decompression sickness, deep venous thrombosis, acute lung pathologies, sinusitis, musculoskeletal trauma, genitourinary emergencies, and ocular emergencies.

Conclusions: While ultrasound has shown promise in addressing various acute conditions, significant knowledge gaps remain, especially in gastrointestinal, cardiac, vascular, and reproductive emergencies. As we venture further into space, expanding our medical expertise becomes vital to ensure astronaut safety and mission success.

Keywords: Aerospace medicine; Diagnostic imaging; Emergencies; Microgravity; Sonography; Space; Space medicine; Spaceflight; Ultrasound.

Publication types

Review