MSGID: 1:317/3 627201a2   
   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Astronauts: Blood clot expert to study blood flow, clot formation in   
   zero gravity    
      
     Date:   
         May 3, 2022   
     Source:   
         University of North Carolina Health Care   
     Summary:   
         This was the first time a blood clot had been found in an astronaut   
         in space, so there was no established method of treatment for DVT   
         in zero gravity.   
      
      
      
   FULL STORY   
   ==========================================================================   
   Are astronauts more likely to develop blood clots during space missions   
   due to zero gravity? That's the question NASA is trying to answer with   
   help from UNC School of Medicine's Stephan Moll, MD, professor in the   
   UNC Department of Medicine. A new publication in Vascular Medicineshows   
   the results of an occupational surveillance program spurred by the   
   development of a deep vein thrombosis (DVT) in the jugular vein of an   
   astronaut, which is described in detail in a New England Journal of   
   Medicinepublication from 2020.   
      
      
   ==========================================================================   
   Moll was consulted by NASA when the discovery of the blood clot was   
   made during the astronaut's mission on the International Space Station   
   (ISS). This was the first time a blood clot had been found in an astronaut   
   in space, so there was no established method of treatment for DVT in   
   zero gravity. Moll, a member of the UNC Blood Research Center and a   
   clinical hematologist, was called upon for his knowledge and treatment   
   experience of DVT on Earth. In the ultimate act of telemedicine, Moll   
   and NASA physicians helped treat the astronaut over several months,   
   until they safely returned to Earth.   
      
   This astronaut's blood clot was asymptomatic -- they didn't have any   
   symptoms that would have otherwise indicated there was a clot. The DVT   
   was discovered when the astronaut was taking ultrasounds of their own   
   neck for a research study on how body fluid is redistributed in zero   
   gravity. If it wasn't for the study, there's no telling what the outcome   
   could have been. That's why Moll has continued to work with NASA to   
   research how blood flow and blood clots behave in space.   
      
   "I've always been a space enthusiast," Moll said. "When I was young I   
   wanted to be an astronaut, so when NASA called on me to help, it was   
   pretty incredible.   
      
   And it's been amazing to then continue working with NASA doing research   
   on blood clots in space that will help develop the health and safety   
   protocols for future space travel."  Moll and fellow researchers, led   
   by NASA's James Pavela, MD, monitored 11 astronauts over a combined   
   total of 2,150 days in zero gravity on the ISS. All astronauts were   
   evaluated before leaving Earth to get a baseline of their blood flow and   
   blood vessel size in the veins of their neck. Once in space, astronauts   
   performed ultrasounds on their own necks with guidance from a radiology   
   team on Earth to monitor any changes that occurred in zero gravity.   
      
   "We expected some changes in flow based on the absence of gravity,"   
   Moll said.   
      
   "Gravity pulls fluid in your body down. It also creates a force on your   
   blood vessels and this increased pressure in the veins of the legs leads   
   to leakage of fluid from the blood vessels into the soft tissues. You   
   can notice this when you stand for a long time and develop swelling in   
   your ankles, feet, and sometimes hands.   
      
   "Without gravity, fluids like blood redistribute in your body. When   
   astronauts arrive in space, the lack of gravity causes the blood   
   vessels in the neck to expand due to fluid shifting to the upper part   
   of the body. Astronauts develop swelling of the neck and face from this   
   shift. That is a normal and expected finding."  The question Moll and   
   NASA wanted to answer is if this difference in flow and vessel size   
   could put astronauts at risk for the development of blood clots.   
      
   While abnormal flow characteristics were recorded in six of the eleven   
   astronauts, none developed blood clots. However, the findings of slowed   
   blood flow in the neck veins, abnormal echo findings on the examination,   
   and even reversal of blood flow in two astronauts raises the question   
   whether these abnormalities could predispose these space travelers to   
   blood clots.   
      
   Because this was a small study, researchers cannot make firm   
   conclusions. Moll says more research is needed, but due to the challenges   
   of such investigations and the small pool of astronauts to participate   
   in future studies, it may take some time to draw definite conclusions.   
      
   In the meantime, this research helps inform what medical supplies, like   
   blood thinners, should be available for current and future spaceflight   
   missions. The data will also help guide the use and development of   
   interventions designed to minimize the potentially increased blood clot   
   risk of spaceflight.   
      
   This study was funded by NASA.   
      
      
   ==========================================================================   
   Story Source: Materials provided by   
   University_of_North_Carolina_Health_Care. Note: Content may be edited   
   for style and length.   
      
      
   ==========================================================================   
   Journal Reference:   
      1. James Pavela, Ashot Sargsyan, Deepak Bedi, Aaron Everson, Jacqueline   
         Charvat, Sara Mason, Benjamin Johansen, Karina Marshall-Goebel,   
         Sarah Mercaldo, Ronak Shah, Stephan Moll. Surveillance for   
         jugular venous thrombosis in astronauts. Vascular Medicine, 2022;   
         1358863X2210866 DOI: 10.1177/1358863X221086619   
   ==========================================================================   
      
   Link to news story:   
   https://www.sciencedaily.com/releases/2022/05/220503102850.htm   
      
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