Dr Karina Oliani
ER Doctor, mountaineer & adventurer
My name is Karina Oliani, and I'm a doctor specializing in Emergency Medicine and Rescue in Remote Areas. Outdoor challenges have always been my passion, and because of this, I've participated in countless expeditions at sea, up mountains, in jungles and in the desert, including climbing Everest 2 times - by the South face in 2013 and North face in 2017. I also love diving and have dived in all the oceans with the biggest predators.
In parallel, I am a producer of audio-visual content and have already produced work for the Globo programs "Fantástico" and "Esporte Espetacular" in Brazil, and I have worked as a presenter and guide for the reality shows "Celebrities' Challenge" and "Extreme Mission" on the Discovery Channel.
For more than four years I have been trying to realize my dream of climbing K2, which is considered to be the most difficult and dangerous mountain to climb on Earth. The first year I couldn't do it because of work commitments, the next year through a lack of sponsorship, and then once again it was not possible as I became very ill after being bitten by a tick. But when you have had a desire for such a long time, you don't give up easily!
The expedition to K2 wasn't easy for me, either physically or mentally. As already mentioned, for most of 2018 I was battling the tick-borne Lyme disease, which is transmitted by the bite of a tick infected with the bacterium Borrelia burgdorferi, and for which I still have to take medications. As it turned out though, I hardly felt the effects of the disease during the climb, probably because of the decreasing oxygen levels during the ascent - I think perhaps the Borrelia didn't like the lack of oxygen!
K2 is a truly beautiful mountain, very impressive, and one that I was always drawn to, maybe because it represents every challenge a climber expects and more. It is situated in the Karakoram mountain range, which is an extension of the Himalayan mountains, and it sits on the borders between Pakistan and China. K2 has been dubbed “The Wild Mountain,” and one in five of the climbers who have attempted to reach its summit have died.
K2 is located in a place so remote and inaccessible that it was only discovered by scientific mapping in 1904, and was only climbed for the first time 50 years later, by an Italian team. In 2000, Waldemar Niclevicz became the first and only Brazilian to have ever reached the summit of K2, and subsequently, I became only the 2nd Brazilian and the 1st Brazilian woman to successfully reach the top.
In all the expedition took a total of 50 days. We first made our way to a local community called Askole, home to just 200 inhabitants and a place that can only be reached using 4x4 vehicles. Then came eight days of trekking through Pakistani villages and completely inhospitable regions to reach the base camp. This involved walking 120 kilometers along an extremely complex trail of ice, snow, glacial sediment, rocks, small deserts and rivers. K2 is definitely not the type of place where you get tired and decide to go home!
We then began the 1st cycle of acclimatization, followed by 4-5 days rest. Acclimatization is extremely important for the body to begin to adapt to the high altitude and prevent more serious side effects. At this time you are submitting your body to a low oxygen environment, and so, your bone marrow understands that it needs to produce more red blood cells to carry the little oxygen that is available.
K2 is not a place for beginners and it is the mind that works the hardest in this situation. In high altitude mountains, 20% of success is physical, and the rest is psychological. In mountains like K2, you deal with a high risk of death, little communication and not much to do, and this can seriously affect your mind.
Consequently, my climbing partner Maximo Kausch and I tried to look upon the expedition with a positive vibe, and without placing pressure on ourselves. Obviously we had concerns, but we tried to do everything calmly, waiting to see what would happen... if we made it - great! If not, that was fine too... We knew the expedition was much more than just the summit. We passed through beautiful landscapes, and saw completely unknown mountains, and this is worth a lot.
We set off for out attempt on the summit at dawn on the 17th July, accompanied by 118 other climbers. But as we were nearing the top on this same day, an avalanche swept down the mountain, injuring a Sherpa and sweeping away two of the fixed ropes needed to continue the rest of the ascent. The mission had to be aborted and everyone returned to base camp. The avalanche meant that of the 120 climbers who would have attempted the summit this season, only 18 decided to continue on with the mission.
After this first attempt to reach the summit, I began to feel that my lungs were feeling a bit wet, namely, the beginning of pulmonary edema, which is common at such extreme altitudes. In mountain medicine, the first medicines to use in this case are Nifedipine, and then Viagra, as they help the vessels in the lungs to relax, preventing the contraction caused by the lack of oxygen and as a consequence, pulmonary hypertension.
Despite feeling exhausted, just 2 days after reaching the base camp we decided to attempt to reach the summit again in another time window that emerged. After all, it could be the last opportunity, as in general, K2 does not give many chances to reach the top in a season.
Persistence, in this case, was the key to our success, and on the 25th of August, exactly one month since our arrival at the mountain, we succeeded in reaching the summit of K2, the second highest mountain in the world, at an altitude of 8,611 meters. As with nearly everything in life, reaching the end goal involves a series of events leading up to it, and our expedition was filled with stories, things learnt and adventures, and above all, the sweet sensation of having fulfilled another dream!
I have to thank wholeheartedly the sponsors of my K2 expedition - Volvo Cars, Pulsar Invest, John John, Outback Steakhouse, and Gillette Venus. And support from Canon, GoPro HERO7, Spot, Puma and The North Face. I am eternally grateful to them for believing in this dream and in my potential.
Dr. Gabriela S. Pilo
Oceanographer, Institute for Marine & Antarctic Studies (University of Tasmania, Australia)
It is quite easy to draw a parallel between ocean and space exploration. Both require a ship, a large sense of adventure, and a love of discovery. But there are more similarities between the ocean and space than simply their ability to feed the imagination of writers, musicians, and curious minds.
The ocean, like space, is still unknown. Similarly to space research, ocean researchers are still trying to fill several knowledge gaps. We’ve advanced a lot since the beginning of modern Oceanography, attributed to the Challenger Expedition in 1872. We have now charted the main ocean currents, from the surface down to the bottom of the ocean, at 6000 m depths. We understand how and where surface waters become dense and sink, creating a conveyor belt that connects the whole planet, travelling for 1000 years before re-surfacing. We also understand that ocean currents interact with the wind, the ocean floor, and with each other, and break into several rotating bodies of water, known as ocean eddies. These eddies spin away, carrying their parent current’s water to distant parts of the ocean. However, as in space, there is still a lot we don’t know. Gaps in ocean research relate to balances of energy and of biogeochemical compounds, and to the response of the ocean to a changing climate.
Considering that there still so much to learn, we often find ourselves in the middle of the ocean looking for answers. This brings up the second similarity between ocean and space research: when you are out there, conditions can get harsh! Open-ocean Oceanographic cruises can last for up to 3 months, having only a few shore stops during this time. Therefore, like in space, an oceanographic vessel must be autonomous for a long period of time. During research cruises, scientists and crew members are putting all their efforts into sampling the water and measuring physical properties of the ocean. Sampling happens under all circumstances, in the middle of the night, in rain, snow, and under very high wave conditions. In addition, icebreaker vessels can go deep into an ice field, and reach the most remote parts of the world. Ocean-sickness, just like space-sickness, often kicks in, as your body gets used to the constant movement. You are also living in a confined space with like-minded people that have one goal: to do science.
But the ocean is not just a large body of water, flowing and crashing against the shore. The bathymetry of the ocean, the chemical elements dissolved in the water, and the animals, microbes, and algae that live in it, are equally important and fascinating. Oceanography is a highly multidisciplinary research field. Therefore, to fully understand the ocean, we need to collaborate. It takes a team of physical oceanographers, marine biologists, geologists, meteorologists, glaciologists, and several other scientists to put the pieces of the puzzle together. This team work builds up our knowledge of the ocean. Just like in the space sciences, collaboration is key! For example, the InnovaSpace Team is composed of experts in life science, telehealth, and engineering.
Finally, the ocean, like space, is vast. We cannot be everywhere, at all times to study it. To obtain global, constant measurements of the ocean we rely on state-of-the-art sensors, similarly to space research. The sensors to measure the ocean are either aboard a series of artificial satellites orbiting the Earth, or in instruments placed in the water. Sensors onboard satellites can measure the sea surface temperature, salinity, and sea surface height. In the water, sensors are aboard floats, mooring arrays, automated underwater vehicles, remotely operated vehicles, gliders, and seals (!). Operational oceanography is a fascinating field of research, and at its heart sits the Argo array, composed of 4000 Argo floats measuring temperature and salinity of the top 2000 m of the ocean since 2005. This array has helped oceanographers to answer important questions on ocean circulation and climate change.
Ultimately, the ocean - just like the space - brings fascination. The excitement of discovery is present both when exploring a deep canyon or a distant quasar. In the end, the ocean is also a final frontier. A frontier, however, closer to home!
Department of Morphological Sciences, ICBS, Federal University of Rio Grande do Sul, Brazil
Amazing as it may seem, as the number of spaceflights has increased and life aboard space stations has become a reality, the effects of high levels of space radiation and microgravity (micro-G) on mammalian reproduction are still largely unknown. Therefore, the study of reproduction in space is a very important subject for the future of space missions. Research conducted with experimental non-mammal animals, such as sea urchins, fish, amphibians, and birds has concluded that micro-G does not prevent animal reproduction. However, mammalian reproduction presents specific features, such as ovulation, sperm and oocyte (egg) transit in the reproductive tract, embryo attachment, implantation and placentation, which are specific to mammalian reproduction and cannot be studied in non-mammal species. Surprisingly, little information is available today on how these processes occur in conditions of microgravity.
A first problem requiring investigation is the supposed difficulty that sperm and egg cells may have to travel along the female reproductive tract to accomplish natural fertilization under micro-G conditions. A project with 100% relevance is NASA’s Micro-11 research, which aims to examine putative motility alterations in human and bull sperm during spaceflight. “Micro-11 provides fundamental data indicating whether successful human reproduction beyond Earth is possible, and whether countermeasures are needed to protect sperm function in space” (NASA). Rapid directional sperm motility is a key factor for successful fertilisation under natural circumstances. Sperm cells need to swim up the uterine cervix, travel through the uterine cavity and fallopian tubes to meet and fertilise the oocyte. To accomplish all these tasks, human sperm respond to chemoattractant signals, to temperature gradient, and to fluid flow. These guidance mechanisms occur naturally along the female reproductive tract and are important for the sperm-egg encounter and for natural fertilisation to occur in the fallopian tubes, but will these mechanisms be sufficient in micro-G?
Experimental studies with mice have revealed impaired male germ cell generation under microgravity conditions. Of concern are alterations seen in the physiology of testicular cells observed under conditions of simulated microgravity, which may obscure the starting point of mechanisms that lead to long-lasting tumorigenic processes. However, a recent research has shown that the deleterious effects of microgravity on germ cell proliferation, oxidative metabolism and autophagy may be, at least partially, prevented by the presence of antioxidants in the germ cell culture medium. This finding represents an important contribution to the current knowledge of microgravity effects on germ cell tumour metabolism and development.
According to estimates, nearly one in six couples worldwide seek out assisted reproduction technologies for having a child. Thus, it is expected that fertility assistance may also be necessary in space due to naturally occurring fertility problems or due to micro-G induced infertility conditions. A report from the 35th annual meeting of the European Society of Human Reproduction and Embryology recently revealed that frozen human sperm retain their viability and fertilising capacity in outer space, similar to sperm samples stored in liquid nitrogen under Earth’s gravity conditions. This represents a reassuring finding, particularly when considering the importance of sperm cryostorage for fertility preservation, such as in the case of cancer patients who may lose their reproductive potential due to oncological treatments. It also allows us to hypothesise that donor intra-uterine insemination may represent a viable option for having a child under the micro-G conditions found in space stations.
The more complex assisted reproduction technology (ART), “in vitro fertilisation” (IVF), developed by Sir Robert Edwards and Dr. Patrick Steptoe, allows fertilisation to occur outside of the body, i.e., outside its natural tubal environment, in a plastic petri dish, giving rise to the term “test-tube” baby. Its main purpose is to promote fertilisation when the natural encounter of sperm and oocyte is not possible, as is the case of women presenting blocked uterine horns. In summary, oocytes are first collected from the ovaries, (performed by transvaginal ovarian puncture and aspiration) and placed in a petri “IVF” dish containing a culture medium that mimics the tubal micro-environment. The male partner produces a sperm sample, which is prepared for mixing with the oocytes, after which the IVF dish is maintained in a warm incubator (37oC) in a laboratory for fertilisation to take place. The sperm must be able to swim and penetrate the oocyte membrane for fertilisation to be accomplished, and to assist this they are placed close together to facilitate their interaction and fusion.
The resulting embryos remain in the incubator for up to six or seven days, before being transferred to the womb. However, fertilisation will not occur under natural or even IVF conditions when the ejaculated sperm do not present rapid directional motility in a condition called asthenospermia, a common cause of unsuccessful reproduction among infertile couples. To help these individuals generate their own descendants, the ART “intracytoplasmic sperm injection” (ICSI) technique was developed by Dr. Gianpietro Palermo. ICSI allows fertilisation to occur even when the sperm sample is poor in terms of number and/or motility.
The technique uses a micromanipulation station fitted to an inverted microscope equipped with contrast optics that enable three-dimensional visualisation of living cells. The ICSI micromanipulation equipment consists of two glass pipettes; a holding pipette to fix the oocyte and an injection pipette to introduce the sperm into the oocyte cytoplasm (see below video). The ICSI insemination strategy allows fertilisation to occur even under unfavourable conditions, and it can perhaps be hypothesised that this technology may be of assistance in the case of sperm motility deficiencies in outer space, where micro-G conditions may prevent natural, unassisted sperm-egg fusion.
Undoubtedly, much more research needs to be performed before we can erase the large question marks that remain as to the likelihood of natural fertilisation taking place in mammals under micro-G conditions, and if required, how effective current assisted reproduction technology would be when using the ART setup and equipment developed on Earth. With talk of future Moon and Mars colonisation and space hotels in the coming decades, there will come a time when human reproduction under microgravity conditions will need to be better addressed if life is to be sustained in off-Earth environments.
Life in research and academia is often busy, with commitments to attend conferences to disseminate your work, learn of what other research is being conducted in your field of interest, and to build a network of like-minded people linked by common themes. InnovaSpace’s Scientific and Strategic Consultant Roberto Fanganiello is no exception to this way of life and travels frequently around the globe, with last week seeing him in Canada attending the 7th International Symposium on Surfaces and Interfaces for Biomaterials (ISSIB, 22-25 July 2019), held at the Quebec City Convention Centre, in Quebec.
His time was well filled with activities over three of the conference days; giving a talk at a tutorial session on the innovative strategies used to design surfaces and interfaces for biosensors, as well as on surface modifications of biomaterials to make them optimal for association with different types of cells; giving a keynote talk at the main conference, on surface modifications of titanium implants to improve bone tissue formation and regeneration; and chairing a session on Future Trends in material and biomaterial sciences.
Surfaces and interfaces in biomaterials are topics of key significance in the fields of biomaterials and tissue engineering, and form a strong scientific platform for technological innovation and economic growth worldwide. Many novel ideas and concepts were shared at this year’s ISSIB Symposium, together with an exchange of information regarding the use of emerging technologies and fundamental advances in biomaterial surfaces and interfaces.
Plans are already afoot for the next edition of the ISSIB Symposium, scheduled to take place in Australia in 2021, and Roberto, among others, is eager to see just how much these technologies will have progressed by then!
The InnovaSpace team in the last years have been involved on a couple of occasions with the innovative activities of Guerilla Science, as they seek to connect the general public with science in new and interesting ways.
The benefits of yoga on Earth are well known, and it is certainly an activity that would improve the health of anyone practicing it regularly. The Guerilla crew have come up with a series of great videos linking dynamic yoga stretches with the effects of microgravity on the human body and mind, assisted by five expert space scientists, one of which is InnovaSpace's very own Space Life Sciences Expert Dr. Lucas Rehnberg, who explains about Space Walks and the problems astronauts face when conducting maintenance tasks on the outside of the International Space Station.
Get out your yoga mats, exercise your body, and stretch your mind learning fascinating facts about the human body in space!
Dr. Lucas Rehnberg
InnovaSpace Space Life Sciences Expert.
Recently I had the pleasure to attend the world’s largest aerospace medicine conference in Las Vegas, the 90th Annual Aerospace Medical Association (AsMA) Conference. This was my second AsMA (@Aero_Med) meeting and it didn’t disappoint.
As a doctor training in the UK with an interest in space medicine, the AsMA conference is a great opportunity to present work, meet other space medicine enthusiasts as well as individuals from different disciplines – but all with a shared passion for space and aerospace. The thought behind this blog was to serve as a taster of what AsMA has to offer to those thinking about pursuing a career in this field or who want to gain an idea of how to become involved. So, this was my experience of the conference:
Day 1 - Monday
Started with an incredible opening session commemorating the 50th anniversary of Apollo 11 and the moon landing.
The panel was moderated by Dr Mike Barratt, astronaut and flight surgeon, and consisted of some giants from the Apollo missions:
- Dr Charles Berry & Dr Bill Carpentier, Apollo flight surgeons.
- Gerry Griffin, Apollo flight director.
The session opened with a specially commissioned video dedicated to the Apollo 11 landing in 1969 and the lead-up time. It was an excellent reminder of what was achieved when a nation came together and set the tone for the discussion, reflecting on their experience of Apollo 11 and the Apollo missions.
Some of my favourite moments of this session include when Dr Berry told a great story of stopping President Nixon from having a meal with the Apollo 11 crew the night before their launch, including a letter he wrote to President Nixon apologising for this. Then flight surgeon Dr Carpentier told us what flight surgeons learnt from the Mercury and Gemini missions, before starting on the Apollo missions. Dr Carpentier also spoke about some of his training, including practicing jumping from a moving helicopter in order that he could give medical assistance to the landing Apollo crews.
Gerry Griffin spoke of the pressure of the Apollo missions and the relief mixed with excitement when the Apollo 11 crew set foot on the aircraft carrier after their landing. He also spoke about the Apollo 1 tragedy, what we learnt from all the Apollo missions, and how this will help human spaceflight now that we are focusing on going back to the Moon.
Closing comments from each of the panel followed a similar theme, summed up best by Gerry Griffin, "We’ve gotta get back to the Moon. It’s been 50 years since we’ve done it...we need to get our mojo back."
In the afternoon, I attended 2 panels; behavioural health in human spaceflight and advancing future space exploration with medical system design. The former panel emphasised the importance of human factors and behaviours for the success of exploration missions. It highlighted the lack of data and long-term follow-up of many of the astronauts, suggesting a need to ensure this occurs with current crew members, and also to better assess and monitor psychological performance.
The latter panel was very interesting, attempting to do predict the impossible; what can go wrong with crewmembers and how do we plan/prepare for it? The list of medical conditions that could occur during a human mission to Mars is extensive, and plans for dealing with such events are still in development. The panel members described risk analysis with all the available current data, also emphasising the importance of an interface between medics and engineers to help design systems to overcome these problems (the old mass, power, volume issue).
This began with the ESAM (European Society of Areospace Medicine) panel. There were talks on the difficult topic of airway management and intubation in microgravity, with some interesting results suggesting that modern video laryngoscopy could be a useful tool in novice healthcare providers in order to increase their success rate. There followed a review of the latest microgravity CPR data in order to develop an evidence-based CPR guideline, and finally Dr Christina Mackaill (@cosmic_scot - one to follow!) talked about some of the terrestrial benefits of hypogravity CPR research.
The afternoon saw an EXCELLENT panel on analog missions, discussing the medical considerations for each one. Speakers included:
I also had the pleasure of presenting some work conducted with the Austrian Space Forum on the AMADEE18 Mars analog mission, looking at fatigue in analog astronauts. The rest of the panel included excellent speakers on current developments for IVA (intra vehicular activity) suits and a portable lower body negative pressure device.
The afternoon session was then dedicated to the medical lessons learnt from the Apollo missions - a great historical look at what they did, what was learnt from it, and how it will shape what we do when going back to the Moon. The session included a review of the main biomedical results and how medical operations were conducted during the Apollo missions, an interesting insight into the food and nutrition of the Apollo crews, and the recovery and quarantine programme of the Apollo Moon landing missions. Truly some giants in the field of space life science, and what they learnt 50 years ago will shape how we return humans to the Moon in the next 10 years!
This day had a good mix of space medicine topics:
I should point out that what I have written here is just my experience of the AsMA meeting this year in Las Vegas; there were so many other great panels that I couldn’t attend, even a course on desert medicine hosted by AsMA (alas, I had to fly home).
For students or young professionals looking to enter this exciting field, I would highly recommend the AsMA conference (next year in Atlanta, Georgia, USA). There are a range of scholarships to help fund attending the conference, check out the AsMA website for details: https://www.asma.org/home
The conference will give you the opportunity to hear from experts, past and present, from NASA, ESA, all branches of the military, flight surgeons, astronauts, engineers and so many more. In addition, there are breakout sessions ranging from luncheons with guest speakers to ‘Speed Mentoring’ to help students and young professionals to network, build relationships and guide them in their next steps for a career in space.
Again, if this is your dream, AsMA is a great place to start. For more information, check out their website, or get in touch for more information. If your a fan of social media, I would also recommend following InnovaSpace on Facebook, Instagram and/or Twitter, and also some of the mentioned individuals in this article - they are just a few of the many space medics out there doing interesting work - and apologies to anyone I missed!
Em janeiro deste ano, a InnovaSpace teve a oportunidade de cativar a atenção de um grupo de estudantes, de 12-14 anos de idade, com apresentações sobre carreiras de cientistas espaciais.
Estudantes da Escola Rainha Dona Amélia, em Lisboa, reuniram-se no auditório junto com a Profa. Berta Ferreira, para aprender mais sobre o papel das mulheres na Era Espacial.
Com os olhos bem atentos, os jovens alunos sentaram-se para assistir à apresentação do Projeto Valentina, a qual começou com uma entusiasmada palestra da Dra. Michele Rosa, que falou sobre seu caminho profissional e científico até se tornar uma pesquisadora da área espacial, juntamente com o trabalho que ela hoje desempenha na posição de Coordenadora da InnovaSpace Portuguese Hub.
A diretora da InnovaSpace Thais Russomano logo após proferiu uma palestra sobre as mulheres que foram pioneiras ao viajar para o espaço, terminando com sua própria carreira, como ela se tornou uma médica espacial e também contou um pouco do seu trabalho nessa área.
Além dessas palestras, o time da InnovaSpace também aproveitou essa interação com os alunos portugueses para apresentar um dos seus mais recentes projetos, chamado de InnovaSpace Box, desenvolvido pelo especialista em Tecnologia da Informação Maurício Rosa. A InnovaSpace Box é de fácil uso, pois possui uma interface simples que permite a interação dinâmica com os vídeos do projeto Kids2Mars, que ocorreu em 2018 – perguntas e respostas sobre uma viagem a Marte e como os astronautas viveriam e trabalhariam em uma missão interplanetária.
Aproximadamente 2 horas de uma interação construtiva e de um compartilhamento de conhecimento ocorreram nesse evento. Esperamos que o time da InnovaSpace tenha conseguido motivar os estudantes presentes a seguir uma carreira em alguma área da ciência, e, em especial, na área espacial. Nossa experiência em Lisboa é apenas o começo de uma longa jornada em projetos educacionais espaciais para escolas em Portugal e outros países de língua portuguesa.
Por favor, entre em contato se houver interesse em saber mais sobre o que o time da InnovaSpace pode oferecer para a sua escola ou seus alunos – Ficamos no aguardo!
Nossos agradecimentos a Profa. Berta Ferreira e a Escola Rainha Dona Amélia por nos receber e propiciar a realização desse projeto. Muito obrigada também ao Fernando Mendes e à Ana Dias, que facilitaram a aproximação com essa instituição, bem como à sua filha Matilda, cuja a pergunta para o astronauta análogo na missão no deserto de Utah representou Portugal na primeira missão do projeto Kids2Mars.
We are very pleased to announce that The Guardian, a prestigious British newspaper established in 1821, published an article this month (22nd Jan 2019) about InnovaSpace Founder and Director Thais Russomano and her pursuit of a career related to space and space travel. Thais is also Senior Lecturer and Deputy Course Director of the MSc in Space Physiology and Health, CHAPS, at King's College London.
The InnovaSpace outreach projects, such as Kids2Mars and Project Valentina, were also highlighted for their efforts to spark the interest of the young towards the STEM areas, and to follow careers linked to future space travel and colonies.
Do have a read and tell us what you think! The Guardian Article
Dr. Kushal Madan
Cardiac Rehabilitation Consultant, Dept. of Cardiology, Sir Ganga Ram Hospital New Delhi India
Here on Earth our arterial blood pressure values are set by the pumping action of our heart and by the resistance of our arteries to blood flow, known as peripheral resistance.
Haemodynamics, or the flow of blood in our circulatory system can be summarised as:
The question is though, what happens to blood pressure in Space? How does the microgravity environment that the human body experiences in the ‘weightlessness’ of space affect it?
Weightlessness during spaceflight immediately leads to a shift of blood and body fluids from the lower to the upper part of the body. As the central blood volume increases, there is an increase in cardiac output. But the head-to-foot blood pressure gradient that exists on Earth is removed, thereby dilating the arterial resistance vessels and reducing systemic vascular resistance.
In the space environment, simultaneous to the increased cardiac output, arterial blood pressure either remains the same or is slightly decreased. So, what is the reason for the systemic vasodilatation leading to a reduction in blood pressure in space? Are these changes short-term or do they persist throughout the spaceflight? In 1996 Fritsch-Yelle et al. concluded that there was a decrease of 5 mmHg in diastolic blood pressure and no change in systolic blood pressure, as measured by ambulatory brachial blood pressure monitoring using a portable equipment over the 2 weeks of a spaceflight.
Ambulatory blood pressure monitoring (ABPM) is a continuous blood pressure recording over a 24-hr period to assess the pattern of variability in arterial blood pressure during rest and exercise. ABPM can detect circadian changes, such as nocturnal dipping and morning surge. According to the American College of Cardiology/American Heart Association 2017 guidelines, a normotensive patient should have a daytime ABPM <120/80 mm Hg, and a night time ABPM < 100/65 mm Hg. This technique can also pick up on the variations in arterial blood pressure due to different environmental and emotional changes, and it can overcome the disadvantages of manual arterial blood pressure recording, such as white coat hypertension.
The use of this technique in aerospace applications has provided valuable information regarding the mechanisms of blood pressure regulation. Another important use of this method of arterial blood pressure monitoring is in assessing the effectiveness of countermeasures applied to reduce the adverse effect of weightlessness on the cardiovascular system. Initial studies conducted on astronauts have shown that ambulatory blood pressure equipment can detect the increase and decrease of blood pressure before, during and after spaceflight. Therefore, it would seem that these ABPM devices have a very useful role to play in detecting the blood pressure changes that occur during the stressful and hostile situations found during space missions.
InnovaSpace Scientific & Strategic Consultant.
On November 21st and 22nd, 2018 I had the pleasure of visiting the laboratory of Prof. Nandu Goswami, at the Medical University of Graz, in Austria. Nandu is an Associate Professor at the university, interim head of the Division of Physiology and Head of the Gravitational Physiology and Medicine research unit. The main areas of study of his research group are cardiovascular physiology, cerebral auto-regulation and space/gravitational physiology, especially using Earth-based models of space flight.
Cardiovascular alterations encountered during space missions, such as a reduction in central venous pressure, cardiac atrophy and decreased vascular responsiveness to standing are major concerns for astronauts during and after spaceflight. On Earth, the ageing process is also linked to physiological deconditioning of the cardiovascular system, which creates a parallel with the changes in human physiology secondary to weightlessness exposure. At the Gravitational Physiology and Medicine research unit, bed rest studies are used as a ground-based simulation of microgravity to further understand the effects of deconditioning, both for the elderly on Earth and astronauts in space. This is also an area of special interest for InnovaSpace Advisor Joan Vernikos, who conducted similar research at NASA for many years and has published scientific articles and books on the topic.
InnovaSpace congratulates Nandu for his work, which is a very interesting area of research and can be seen as a good example of technological and knowledge transfer from space to Earth. Together with the InnovaSpace team, I hope we can one day collaborate with Prof. Goswami and his group in Graz.