Hamilton Douglas, Smart Kieran, Melton Shannon, Polk James D, Johnson-Throop Kathy
Wyle Life Sciences, Houston, TX 77058-2769, USA.
J Trauma. 2008 Apr;64(4 Suppl):S354-63. doi: 10.1097/TA.0b013e31816c005d.
The US-based health care system of the International Space Station contains several subsystems, the Health Maintenance System, Environmental Health System and the Countermeasure System. These systems are designed to provide primary, secondary and tertiary medical prevention strategies. The medical system deployed in low Earth orbit for the International Space Station is designed to support a "stabilize and transport" concept of operations. In this paradigm, an ill or injured crewmember would be rapidly evacuated to a definitive medical care facility (DMCF) on Earth, rather than being treated for a protracted period on orbit. The medical requirements of the short (7 day) and long duration (up to 6 months) exploration class missions to the moon are similar to low Earth orbit class missions but also include an additional 4 to 5 days needed to transport an ill or injured crewmember to a DMCF on Earth. Mars exploration class missions are quite different in that they will significantly delay or prevent the return of an ill or injured crewmember to a DMCF. In addition the limited mass, power and volume afforded to medical care will prevent the mission designers from manifesting the entire capability of terrestrial care. National Aeronautics and Space Administration has identified five levels of care as part of its approach to medical support of future missions including the Constellation program. To implement an effective medical risk mitigation strategy for exploration class missions, modifications to the current suite of space medical systems may be needed, including new crew medical officer training methods, treatment guidelines, diagnostic and therapeutic resources, and improved medical informatics.
国际空间站以美国为基地的医疗保健系统包含几个子系统,即健康维护系统、环境卫生系统和对策系统。这些系统旨在提供一级、二级和三级医疗预防策略。为国际空间站部署在近地轨道的医疗系统旨在支持“稳定并转运”的操作理念。在这种模式下,生病或受伤的机组人员将被迅速疏散到地球上的确定性医疗设施(DMCF),而不是在轨道上接受长时间治疗。前往月球的短期(7天)和长期(长达6个月)探索级任务的医疗需求与近地轨道级任务相似,但还包括将生病或受伤的机组人员运送到地球上的DMCF所需的额外4至5天时间。火星探索级任务则大不相同,因为这将显著延迟或阻止生病或受伤的机组人员返回DMCF。此外,提供给医疗保健的有限质量、功率和体积将使任务设计者无法展现地面医疗的全部能力。美国国家航空航天局已确定了五个护理级别,作为其对包括星座计划在内的未来任务医疗支持方法的一部分。为了对探索级任务实施有效的医疗风险缓解策略,可能需要对当前的一系列太空医疗系统进行修改,包括新的机组医务人员培训方法、治疗指南、诊断和治疗资源,以及改进医疗信息学。