Lumbar puncture during spaceflight: Operational considerations, constraints, concerns, and limitations

Aviation Space and Environmental Medicine

Volumn 85, Issue 12, 2014, Pages 1209-1213

  Barr, Yael R ^a  

^a UNIVERSITY OF TEXAS MEDICAL BRANCH   (United States)

Author keywords

Astronauts; Intracranial pressure; Microgravity

Indexed keywords

ANATOMY AND HISTOLOGY; BACK; CLINICAL COMPETENCE; EXERCISE; HEADACHE; HEMORRHAGE; HUMAN; INFECTION; INTRACRANIAL HYPERTENSION; MICROGRAVITY; PATIENT POSITIONING; PHYSIOLOGY; PUNCTURE; SPACE FLIGHT; SPINE;

CLINICAL COMPETENCE; HEADACHE; HEMORRHAGE; HUMANS; HYPOGRAVITY; INFECTION; INTRACRANIAL HYPERTENSION; LUMBOSACRAL REGION; PATIENT POSITIONING; RESTRAINT, PHYSICAL; SPACE FLIGHT; SPINAL PUNCTURE; SPINE;

EID: 84916598282     PISSN: 00956562     EISSN: None     Source Type: Journal    
DOI: 10.3357/ASEM.3674.2014     Document Type: Review

References (42)

1. Arendt K, Demaerschalk BM, Wingerchuk DM, Camann W. Atraumatic lumbar puncture needles: after all these years, are we still missing the point? Neurologist 2009; 15: 17-20.
2. Armon C, Evans RW. Addendum to assessment: prevention of post-lumbar puncture headaches: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2005; 65: 510-2.
3. Baker ES, Barrat MR, Wear M. Human response to space flight. In: Barratt MR, Pool SL, eds. Principles of clinical medicine for space flight. New York: Springer; 2008.
4. Boon JM, Abrahams PH, Meiring JH, Welch T. Lumbar puncture: anatomical review of a clinical skill. Clin Anat 2004; 17; 544-53.
5. Buckey JC Jr, Gaffney FA, Lane LD, Levine BD, Watenpaugh DE, et al. Central venous pressure in space. J Appl Physiol 1996; 81; 19-25.
6. Buckey JC Jr, Homick JL, eds. The Neurolab Spacelab mission: neuroscience research in space. Houston, TX: NASA; 2003. Report No.: NASA SP-535.
7. Campbell MR, Billica RD, Johnston SL III, Muller MS. Performance of advanced trauma life support procedures in microgravity. Aviat Space Environ Med 2002; 73: 907-12.
8. Campbell MR, Williams DR, Buckey JC Jr, Kirkpatrick AW. Animal surgery during spaceflight on the Neurolab Shuttle mission. Aviat Space Environ Med 2005; 76: 589-93.
9. Carson D, Serpell M. Choosing the best needle for diagnostic lumbar puncture. Neurology 1996; 47: 33-7.
10. Chin KJ, Chan VW, Ramlogan R, Perlas A. Real-time ultrasoundguided spinal anesthesia in patients with a challenging spinal anatomy: two case reports. Acta Anaesthesiol Scand 2010; 54; 252-5.
11. Crucian B, Sams C. Immune system dysregulation during spaceflight: clinical risk for exploration-class missions. J Leukoc Biol 2009; 86: 1017-8.
12. Cummings T, Jones JS. Use of ultrasonography for lumbar puncture. Emerg Med J 2007; 24: 492-3.
13. Davet J, Clavel B, Datas L, Mani-Ponset L, Maurel D, et al. Choroidal readaptation to gravity in rats after spaceflight and head-down tilt. J Appl Physiol 1998; 84: 19-29.
14. Evans RW. Complications of lumbar puncture. Neurol Clin 1998; 16; 83-105.
15. Farr W, Gonzalez MJ, Garbauskas H, Zinderman CE, LaMar JE 2nd. Suspected meningococcal meningitis on an aircraft carrier. Mil Med 2004; 169: 684-6.
16. Ferre RM, Sweeney TW, Strout TD. Ultrasound identification of landmarks preceding lumbar puncture: a pilot study. Emerg Med J 2009; 26: 276-7.
17. Fong B, VanBendegom JM. Lumbar puncture. In: Reichman E, Simon RR, eds. Emergency medicine procedures: McGraw-Hill Professional; 2003:859-80.
18. Friedman DI. Idiopathic intracranial hypertension. Curr Pain Headache Rep 2007; 11: 62-8.
19. Gabrion J, Herbute S, Oliver J, Maurel D, Davet J, et al. Choroidal responses in microgravity. (SLS-1, SLS-2 and hindlimbsuspension experiments). Acta Astronaut 1995; 36: 439-48.
20. Gerscovich EO, Maslen L, Cronan MS, Poirier V, Anderson MW, et al. Spinal sonography and magnetic resonance imaging in patients with repaired myelomeningocele: comparison of modalities. J Ultrasound Med 1999; 18: 655-64.
21. Guéguinou N, Huin-Schohn C, Bascove M, Bueb JL, Tschirhart E, et al. Could spaceflight-associated immune system weakening preclude the expansion of human presence beyond Earth's orbit? J Leukoc Biol 2009; 86: 1027-38.
22. International Space Station Integrated Medical Group - Medical Checklist ISS (All Expeditions). Houston: National Aeronautics and Space Administration; 2008.
23. Jennings T. Space adaptation syndrome is caused by elevated intracranial pressure. Med Hypotheses 1990; 32: 289-91.
24. Johnston SL, Campbell MR, Scheuring R, Feiveson AH. Risk of herniated nucleus pulposus among U.S. astronauts. Aviat Space Environ Med 2010; 81: 566-74.
25. Kaplan CP, Miner ME, McGregor JM. Pseudotumour cerebri: risk for cognitive impairment? Brain Inj 1997; 11: 293-303.
26. Kershner D, Binhammer R. Intrathecal ligaments and nerve root tension: possible sources of lumbar pain during spaceflight. Aviat Space Environ Med 2004; 75: 354-8.
27. Kirkpatrick AW, Ball CG, Campbell M, Williams DR, Parazynski SE, et al. Severe traumatic injury during long duration spaceflight: light years beyond ATLS. J Trauma Manag Outcomes 2009; 3: 4.
28. Lakin WD, Stevens SA, Penar PL. Modeling intracranial pressures in microgravity: the influence of the blood-brain barrier. Aviat Space Environ Med 2007; 78: 932-6.
29. Mader TH, Gibson CR, Pass AF, Kramer LA, Lee AG, et al. Optic disc edema, globe flattening, choroidal folds, and hyperopic shifts observed in astronauts after long-duration space flight. Ophthalmology 2011; 118: 2058-69.
30. Marshburn T. Acute care. In: Barratt M, Pool SL, eds. Principles of clinical medicine for space flight. New York: Springer; 2008.
31. Masseguin C, Corcoran M, Carcenac C, Daunton NG, Guell A, et al. Altered gravity downregulates aquaporin-1 protein expression in choroid plexus. J Appl Physiol 2000; 88: 843-50.
32. Risk of spaceflight-induced intracranial hypertension/vision alterations. Human Research Roadmap [Internet]. Houston, TX: NASA Johnson Space Center; 2013. Available from: http:// humanresearchroadmap.nasa.gov/Risks/?i 5 105.
33. Peterson MA, Abele J. Bedside ultrasound for difficult lumbar puncture. J Emerg Med 2005; 28: 197-200.
34. Rafiq A, Broderick TJ, Williams DR, Doarn CR, Jones JA, Merrell RC. Assessment of simulated surgical skills in parabolic microgravity. Aviat Space Environ Med 2005; 76: 385-91.
35. Rafiq A, Hummel R, Lavrentyev V, Derry W, Williams D, Merrell RC. Microgravity effects on fine motor skills: tying surgical knots during parabolic flight. Aviat Space Environ Med 2006; 77; 852-6.
36. Ross MD. Changes in ribbon synapses and rough endoplasmic reticulum of rat utricular macular hair cells in weightlessness. Acta Otolaryngol 2000; 120: 490-9.
37. Sayson JV, Hargens AR. Pathophysiology of low back pain during exposure to microgravity. Aviat Space Environ Med 2008; 79; 365-73.
38. Sørensen PS, Thomsen AM, Gjerris F. Persistent disturbances of cognitive functions in patients with pseudotumor cerebri. Acta Neurol Scand 1986; 73: 264-8.
39. Speich JE, Cagle YD, Rafiq A, Merrell RC, Doarn CR, Broderick TJ. Evaluation of surgical skills in microgravity using force sensing. Med Eng Phys 2005; 27: 687-93.
40. Sternbach G. Lumbar puncture. J Emerg Med 1985; 2: 199-203.
41. Williams J, Lye DC, Umapathi T. Diagnostic lumbar puncture: minimizing complications. Intern Med J 2008; 38: 587-91.
42. Yri HM, Fagerlund B, Forchhammer HB, Jensen RH. Cognitive function in idiopathic intracranial hypertension: a prospective case-control study. BMJ Open 2014; 4: e004376.