Systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight
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 v...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2024-02-01
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| Series: | npj Microgravity |
| Online Access: | https://doi.org/10.1038/s41526-024-00356-w |
| _version_ | 1797273731225092096 |
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| author | Antoine Elias Tobias Weber David A. Green Katie M. Harris Jonathan M. Laws Danielle K. Greaves David S. Kim Lucia Mazzolai-Duchosal Lara Roberts Lonnie G. Petersen Ulrich Limper Andrej Bergauer Michael Elias Andrew Winnard Nandu Goswami |
| author_facet | Antoine Elias Tobias Weber David A. Green Katie M. Harris Jonathan M. Laws Danielle K. Greaves David S. Kim Lucia Mazzolai-Duchosal Lara Roberts Lonnie G. Petersen Ulrich Limper Andrej Bergauer Michael Elias Andrew Winnard Nandu Goswami |
| author_sort | Antoine Elias |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-07T14:48:28Z |
| format | Article |
| id | doaj.art-3d30e8afb945477d87a308f93e0cd8d1 |
| institution | Directory Open Access Journal |
| issn | 2373-8065 |
| language | English |
| last_indexed | 2024-03-07T14:48:28Z |
| publishDate | 2024-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Microgravity |
| spelling | doaj.art-3d30e8afb945477d87a308f93e0cd8d12024-03-05T19:51:20ZengNature Portfolionpj Microgravity2373-80652024-02-0110111710.1038/s41526-024-00356-wSystematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflightAntoine Elias0Tobias Weber1David A. Green2Katie M. Harris3Jonathan M. Laws4Danielle K. Greaves5David S. Kim6Lucia Mazzolai-Duchosal7Lara Roberts8Lonnie G. Petersen9Ulrich Limper10Andrej Bergauer11Michael Elias12Andrew Winnard13Nandu Goswami14Cardiology and Vascular Medicine, Sainte Musse Hospital, Toulon Hospital CentreSpace Medicine Team (HRE-OM), European Astronaut Center (EAC), European Space Agency (ESA)Space Medicine Team (HRE-OM), European Astronaut Center (EAC), European Space Agency (ESA)Faculty of Medicine, Memorial University of NewfoundlandUniversity of Northumbria at NewcastleFaculty of Health, University of WaterlooSpace Medicine Team (HRE-OM), European Astronaut Center (EAC), European Space Agency (ESA)Department of Angiology, Lausanne UniversityKing’s Thrombosis Centre, Department of Haematological Medicine, King’s College Hospital NHS Foundation TrustDepartment of Aeronautics and Astronautics, Massachusetts Institute of TechnologyGerman Aerospace Center (DLR), Institute of Aerospace MedicineDepartment of Surgery, LKH SüdsteiermarkCritical Care Medicine, St. Vincent’s Medical Center, Hartford HealthcareSpace Biomedicine Systematic Review Methods GroupDivision of Physiology, Otto Loewi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of GrazAbstract 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.https://doi.org/10.1038/s41526-024-00356-w |
| spellingShingle | Antoine Elias Tobias Weber David A. Green Katie M. Harris Jonathan M. Laws Danielle K. Greaves David S. Kim Lucia Mazzolai-Duchosal Lara Roberts Lonnie G. Petersen Ulrich Limper Andrej Bergauer Michael Elias Andrew Winnard Nandu Goswami Systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight npj Microgravity |
| title | Systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight |
| title_full | Systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight |
| title_fullStr | Systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight |
| title_full_unstemmed | Systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight |
| title_short | Systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight |
| title_sort | systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight |
| url | https://doi.org/10.1038/s41526-024-00356-w |
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