IT'S JUST ROCKET SURGERY: SURGICAL CARE AND THE FUTURE OF HUMAN SPACE FLIGHT

Objectives: The NASA medical community has enjoyed a boom in research and understanding of the biomedical implications of spaceflight exposure in recent years. Nearly every physiologic system is impacted, and many of these effects have terrestrial parallels that become most apparent in austere, resource-limited settings.
The Space Surgery Association, an interdisciplinary organization with >250 personnel, rendering extensive collective expertise in Surgery, Anesthesiology, and Critical Care, seeks to advance current capabilities for care in the spaceflight environment through a variety of scientific and innovation-oriented initiatives. This presentation will serve to set the stage for current and future spaceflight-related surgical research, laying a foundation for the optimization of medical and surgical care for astronauts and civilian spacefarers.

Methods: An in-depth PubMed literature review encompassed over one hundred papers (1996-2022) pertaining to medical and surgical care in remote and resource-limited environments including space, identifying the elements most critical for ensuring crew health and safety from a surgical perspective.

Results: Spaceflight has profound systemic physiologic effects, including, but not limited to: pronounced cephalad fluid shifts; changes in central venous pressure with stagnation and clot development in the jugular venous network; vision changes with hyperopic shifts as much as +1.75 diopters; immune system dysregulation with increased propensity for bacterial and latent viral infection; rapid, clinically significant reductions in muscle volume and fiber area with unloading in weightlessness; and increased incidence of nephrolithiasis and urinary retention in microgravity. The surgical implications of these findings are significant and merit greater awareness and further dedicated study.

Conclusion: To fulfill the global space sector’s collective vision for the advancement of human spaceflight, the broader medical community must design an innovative, collaborative plan for optimizing crew health and performance, with consideration given to the Surgical and Critical Care domains.