Hayden Jennifer A, Pantalos George M, Burgess James E, Burgess James E
Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
Cardiovascular Innovation Institute, University of Louisville, Louisville, KY, USA.
Aviat Space Environ Med. 2013 Dec;84(12):1298-303. doi: 10.3357/asem.3751.2013.
Expeditionary spaceflight is fraught with significant risks to human health, including trauma and other emergency medical events. To address several of the basic challenges of surgical care in reduced gravity, we are developing the Aqueous Immersion Surgical System (AISS), an optically clear enclosure pressurized by a fluid medium. The AISS is designed to prevent contamination of the spacecraft with blood and tissue debris, reduce intraoperative blood loss, and maintain visualization of the operative field.
An early prototype of the AISS was tested in reduced gravity during parabolic flight. A clear, aqueous field was created in a watertight chamber containing a mock vascular network. Hemorrhage was simulated by severing several of the analogue vessels. Experiments were performed to evaluate the benefits of surrounding a surgical cavity with fluid medium, as compared to an air environment, with respect to maintaining a clear view and achieving hemostasis.
Qualitative evaluation of audio and video recorded during parabolic flight confirm AISS capacity to maintain visualization of the surgical field during a hemorrhage situation and staunch bleeding by raising interchamber pressure.
Evaluation of the AISS in reduced gravity corroborates observations in the literature regarding the difficulty in maintaining visualization of the surgical field when performing procedures in an air environment. By immersing the surgical field in fluid we were able to apply suction directly to the hemorrhage and also achieve hemostasis.
远征太空飞行对人类健康存在重大风险，包括创伤和其他紧急医疗事件。为应对低重力环境下外科护理的一些基本挑战，我们正在研发水浸式手术系统（AISS），这是一种由流体介质加压的光学透明外壳。AISS旨在防止血液和组织碎片污染航天器，减少术中失血，并保持手术视野的可视化。
AISS的早期原型在抛物线飞行的低重力环境下进行了测试。在一个装有模拟血管网络的水密腔室内创建了一个清澈的水场。通过切断几根模拟血管来模拟出血。进行实验以评估与空气环境相比，用流体介质包围手术腔在保持清晰视野和实现止血方面的益处。
对抛物线飞行期间录制的音频和视频进行的定性评估证实，AISS能够在出血情况下保持手术视野的可视化，并通过提高腔室间压力来止血。
在低重力环境下对AISS的评估证实了文献中的观察结果，即在空气环境中进行手术时难以保持手术视野的可视化。通过将手术视野浸入流体中，我们能够直接对出血部位进行抽吸并实现止血。
