Abstract

Artificial Gravity generated by Short Arm Human Centrifuges is a promising multi-system countermeasure for physiological deconditioning during long duration space flights. To allow a continuous assessment of cardiovascular hemodynamics during centrifugation, a telerobotic robotic system holding an ultrasound probe has been installed on a Short Arm Human Centrifuge. A feasibility study was conducted to define the use capabilities and limitations of such a novel method. The objective of this study is to estimate the reproducibility and precision of remotely controlled vascular ultrasound assessment under centrifugation by assessing peripheral vascular diameter and wall distension. Four repeated centrifugation runs of 5 min, with 2.4 g at feet level, were performed including a 15 min rest between each run for a group of eight healthy male volunteers. Vascular diameter and distention were assessed for the common carotid artery (CCA) and the femoral artery (FA) by ultrasound imaging using a 10 MHz linear array probe (Mylab1, Esaote). Ultrasound measurements were consecutively performed: a) by an expert user in hand-held mode in standing as well as supine position, b) using the telerobotic arm without centrifugation as baseline and c) using the telerobotic arm during centrifugation. Vascular responses were compared between baseline and under centrifugation. Inter-, intra-registration and group variability have been assessed for hand-held and remotely controlled examination. The results show that intra-registration variability, σh , was always smaller than inter-registration variability, σm, that is in turned smaller than the inter-subject variability σg (σh < σm < σg). Centrifugation caused no significant changes in CCA diameter but a lower carotid distension compared to manual and robotic ultrasound in supine position (p < 0.05). Femoral diameter was significantly decreased in hypergravity compared to robotic sonography without centrifugation. A good reproducibility and precision of the remotely controlled vascular ultrasound assessment under centrifugation could be demonstrated. In conclusion, arterial wall dynamics can be precisely assessed for the CCA and femoral artery during centrifugation using a telerobotic ultrasound measurement system. Potential improvements to further enhance reproducibility and safety of the system are discussed.

Highlights

  • In preparation for the phase of manned long term spaceflight exploration a more profound understanding of cardiovascular responses to gravitational load is crucial

  • A telerobotic ultrasound system for vascular sonography has been built on the DLR Short Arm Human Centrifuge (Frett et al 2014a) that can be used in hypergravity conditions up to +6 g

  • The carotid distension is significantly lower during centrifugation compared to manual, and, robotic (p < 0.05) sonography in supine position without centrifugation (p < 0.05)

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Summary

Introduction

In preparation for the phase of manned long term spaceflight exploration a more profound understanding of cardiovascular responses to gravitational load is crucial. It is possible to assess non-invasively and in real time, arterial diameter and wall distension at peripheral arteries as the Common Carotid Artery (CCA) or the femoral artery (FA) These methods, based on radio-frequency signal techniques, are recognized as the gold standard in arterial wall dynamics measurement. While telerobotic systems have been developed for various clinical applications (Dogangil et al 2010; Marescaux and Rubino 2003; Evans et al 2018) their employment on a human centrifuge requires specific safety measures. For this purpose, a telerobotic ultrasound system for vascular sonography has been built on the DLR Short Arm Human Centrifuge (Frett et al 2014a) that can be used in hypergravity conditions up to +6 g. Results were analyzed for inter-subject in terms of inter-registration variability as well as intra-measurement variability

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