关于在太空飞行中使用超声波进行静脉评估和静脉血栓筛查的系统性综述。

IF 4.4 1区 物理与天体物理 Q1 MULTIDISCIPLINARY SCIENCES
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
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引用次数: 0

摘要

在太空飞行期间,静脉超声(V-US)对深静脉血栓(DVT)诊断的有效性尚不清楚,在这种情况下的诊断准确性和诊断管理研究中也难以确定。我们对太空飞行中上半身静脉系统使用 V-US 的情况进行了系统回顾,以确定与微重力相关的变化和静脉干预对扭转这些变化的影响,并根据地面标准评估太空飞行 V-US 的适宜性。经过专家小组讨论和对地面诊断研究的审查,开发了一个适当性工具,包括与乘员经验、飞行中设备、评估场所、超声模式和深静脉血栓诊断相关的标准。微重力相关结果显示颈内静脉(IJV)横截面积和压力增加与血流减少、停滞和逆流有关。平均而言,这些变化对使用下半身负压、手镯、瓦尔萨尔瓦和穆勒动作以及压迫对侧颈内静脉的静脉干预措施做出了反应。与地面标准相比,太空飞行 V-US 并不符合所有适当性标准。在深静脉血栓研究(n = 3)中,只报告了一起血栓形成,只有超声模式标准符合标准。在其他研究(n = 15)中,除乘员经验标准外,所有标准都是适当的,只有四项研究的乘员经验标准是适当的。未来的实践和研究应考虑与微重力相关的变化,评估静脉干预的个体效应,并采用基于地球的 V-US 标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Systematic review of the use of ultrasound for venous assessment and venous thrombosis screening in spaceflight.

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.

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来源期刊
npj Microgravity
npj Microgravity Physics and Astronomy-Physics and Astronomy (miscellaneous)
CiteScore
7.30
自引率
7.80%
发文量
50
审稿时长
9 weeks
期刊介绍: A new open access, online-only, multidisciplinary research journal, npj Microgravity is dedicated to publishing the most important scientific advances in the life sciences, physical sciences, and engineering fields that are facilitated by spaceflight and analogue platforms.
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