NOTE: End date changed to 10/1/2020 as Dr. Steven Laurie took over the project in August 2020 (Ed., 7/15/21)

NOTE: End date changed to 3/31/2022 per C. Ribeiro/HHC/HRP JSC (Ed., 5/6/21)

NOTE: End date changed to 1/29/2021 per J. McFather/HRP JSC (Ed., 10/15/18)

NOTE: End date is 9/30/2018 per PI (Ed., 7/8/15)

NOTE: Risk/Gap changes per IRP Rev E (Ed., 3/24/14)

In order to determine the effect of space flight on the headward fluid shift and subsequent redistribution across fluid compartments, biochemical, ultrasound, and other non-invasive cardiovascular measures will be performed before launch, during flight, and after landing. Total body water, extracellular, and intracellular fluid volume will be determined by biochemical dilution techniques. Ultrasound will be used to assess upper vs. lower body interstitial fluid and vascular flow and structure changes, ocular dimensions and optic nerve sheath diameter, and jugular venous pressure. Near infrared spectroscopy will be used to measure lower vs. upper body local tissue hydration, and total peripheral resistance will be calculated from noninvasively acquired blood pressure and cardiac output.

It is currently unclear why only some astronauts experience vision disturbances with space flight. It is hypothesized that astronauts respond differently to the fluid shift inflight and that this impacts changes in ocular structure and function changes. The goal of this study is to test this hypothesis. In doing so, this proposal directly addresses the Integrated Research Plan Gap Cardiovascular (CV)7: How are fluids redistributed in-flight? and Gap Vision Impairment and Intracranial Pressure (VIIP)1: What is the etiology of visual acuity and ocular structural and function changes seen in-flight and post-flight? The research proposed here will determine the effect of long duration space flight on fluid shifts and subsequent redistribution across fluid compartments and attempt to discern the contribution of these adaptations to changes in ocular structure and function.

NOTE: This study was merged with investigations from Dr. Alan Hargens (Fluid distribution before, during and after prolonged space flight) and Dr. Scott Dulchavsky (Microgravity associated compartmental equilibration) resulting in a comprehensive study titled “Fluid Shifts Before, During and After Prolonged Space Flight and Their Association with Intracranial Pressure and Visual Impairment” (short title: Fluid Shifts).

NOTE: Continued by "Distribution of Body Fluids during Long Duration Space Flight and Subsequent Effects on Intraocular Pressure and Vision Disturbance (PI: Laurie)" due to Dr. Stenger's move to Element Scientist for Human Health & Countermeasures element.

Data collected as a part of this project were included in two presentations at the Human Research Program Investigators' Workshop in Galveston, TX, invited oral presentations at the Humans in Space Annual Meeting in Dubai, United Arab Emirates; University of Oregon Department of Human Physiology Seminar Series, Eugene, OR; Loma Linda University Integrated Biomedical Science Seminar, Loma Linda, CA; the Blind Veterans Association Annual Conference, Zoom Virtual Meeting; and the Rice University Keck Seminar, Zoom Virtual Meeting. In addition, a crew report was completed to highlight individual results from that crewmembers participation in this study.

Partial results from this investigation were made available as part of 2 publications in the journals JAMA Ophthalmology and JAMA Network. Results published in JAMA Network revealed the first time a venous thrombosis was identified in a crewmember during space flight. This resulted in a number of news requests and media coverage.

NOTE: Continued by "Distribution of Body Fluids during Long Duration Space Flight and Subsequent Effects on Intraocular Pressure and Vision Disturbance (PI: Laurie)" due to Dr. Stenger's move to Element Scientist for Human Health & Countermeasures element. See that project for additional reporting and for other CoInvestigators associated with the "Fluid Shifts" project over the life of the project.

NOTE: End date changed to 10/1/2020 as Dr. Steven Laurie took over the project in August 2020 (Ed., 7/15/21)

NOTE: End date changed to 1/29/2021 per J. McFather/HRP JSC (Ed., 10/15/18)

NOTE: End date is 9/30/2018 per PI (Ed., 7/8/15)

NOTE: Risk/Gap changes per IRP Rev E (Ed., 3/24/14)

In order to determine the effect of space flight on the headward fluid shift and subsequent redistribution across fluid compartments, biochemical, ultrasound, and other non-invasive cardiovascular measures will be performed before launch, during flight, and after landing. Total body water, extracellular, and intracellular fluid volume will be determined by biochemical dilution techniques. Ultrasound will be used to assess upper vs. lower body interstitial fluid and vascular flow and structure changes, ocular dimensions and optic nerve sheath diameter, and jugular venous pressure. Near infrared spectroscopy will be used to measure lower vs. upper body local tissue hydration, and total peripheral resistance will be calculated from noninvasively acquired blood pressure and cardiac output.

It is currently unclear why only some astronauts experience vision disturbances with space flight. It is hypothesized that astronauts respond differently to the fluid shift inflight and that this impacts changes in ocular structure and function changes. The goal of this study is to test this hypothesis. In doing so, this proposal directly addresses the Integrated Research Plan Gap Cardiovascular (CV)7: How are fluids redistributed in-flight? and Gap Vision Impairment and Intracranial Pressure (VIIP)1: What is the etiology of visual acuity and ocular structural and function changes seen in-flight and post-flight? The research proposed here will determine the effect of long duration space flight on fluid shifts and subsequent redistribution across fluid compartments and attempt to discern the contribution of these adaptations to changes in ocular structure and function.

NOTE: This study was merged with investigations from Dr. Alan Hargens (Fluid distribution before, during and after prolonged space flight) and Dr. Scott Dulchavsky (Microgravity associated compartmental equilibration) resulting in a comprehensive study titled “Fluid Shifts Before, During and After Prolonged Space Flight and Their Association with Intracranial Pressure and Visual Impairment” (short title: Fluid Shifts).

Within this reporting period 2 preflight, 4 inflight, and 2 post-flight tests were completed. To date, all pre/in/post-flight data collection has been completed on the first 10 subjects for this experiment. The final 3 subjects will require a total of 4 more inflight sessions and 7 more post-flight sessions. This is expected to be completed by September of 2020.

Data collected as a part of this project were included in two presentations and 3 posters at the Human Research Program Investigators' Workshop in Galveston, TX, an oral presentation at the International Society for Gravitational Physiology conference in Nagoya, Japan, a poster at the American Society for Gravitational and Space Research conference in Washington, D.C., and as two oral presentations and a poster at the Association for Research in Vision and Ophthalmology annual conference in Vancouver, Canada.

Preliminary results from this investigation have been shared with the Human Health and Countermeasures Element, which have informed the Risk status and guided other grant solicitations.

NOTE: End date changed to 1/29/2021 per J. McFather/HRP JSC (Ed., 10/15/18)

NOTE: End date is 9/30/2018 per PI (Ed., 7/8/15)

NOTE: Risk/Gap changes per IRP Rev E (Ed., 3/24/14)

In order to determine the effect of space flight on the headward fluid shift and subsequent redistribution across fluid compartments, biochemical, ultrasound, and other non-invasive cardiovascular measures will be performed before launch, during flight, and after landing. Total body water, extracellular, and intracellular fluid volume will be determined by biochemical dilution techniques. Ultrasound will be used to assess upper vs. lower body interstitial fluid and vascular flow and structure changes, ocular dimensions and optic nerve sheath diameter, and jugular venous pressure. Near infrared spectroscopy will be used to measure lower vs. upper body local tissue hydration, and total peripheral resistance will be calculated from noninvasively acquired blood pressure and cardiac output.

It is currently unclear why only some astronauts experience vision disturbances with space flight. It is hypothesized that astronauts respond differently to the fluid shift inflight and that this impacts changes in ocular structure and function changes. The goal of this study is to test this hypothesis. In doing so, this proposal directly addresses the Integrated Research Plan Gap Cardiovascular (CV)7: How are fluids redistributed in-flight? and Gap Vision Impairment and Intracranial Pressure (VIIP)1: What is the etiology of visual acuity and ocular structural and function changes seen in-flight and post-flight? The research proposed here will determine the effect of long duration space flight on fluid shifts and subsequent redistribution across fluid compartments and attempt to discern the contribution of these adaptations to changes in ocular structure and function.

NOTE: This study was merged with investigations from Dr. Alan Hargens (Fluid distribution before, during and after prolonged space flight) and Dr. Scott Dulchavsky (Microgravity associated compartmental equilibration) resulting in a comprehensive study titled “Fluid Shifts Before, During and After Prolonged Space Flight and Their Association with Intracranial Pressure and Visual Impairment” (short title: Fluid Shifts).

Within this reporting period, the three final subjects were pitched and have consented to participate in this experiment. Pre-flight baseline data collection is complete on two of these subjects.

Four presentations were made at the Human Research Program Investigators' Workshop in Galveston, including an oral presentation during the Spaceflight Associated Neuro-ocular Syndrome session.

Preliminary results from this investigation have been shared with the Human Health and Countermeasures Element, which have informed the Risk status and guided other grant solicitations.

NOTE: End date changed to 1/29/2021 per J. McFather/HRP JSC (Ed., 10/15/18)

NOTE: End date is 9/30/2018 per PI (Ed., 7/8/15)

NOTE: Risk/Gap changes per IRP Rev E (Ed., 3/24/14)

In order to determine the effect of space flight on the headward fluid shift and subsequent redistribution across fluid compartments, biochemical, ultrasound, and other non-invasive cardiovascular measures will be performed before launch, during flight, and after landing. Total body water, extracellular, and intracellular fluid volume will be determined by biochemical dilution techniques. Ultrasound will be used to assess upper vs. lower body interstitial fluid and vascular flow and structure changes, ocular dimensions and optic nerve sheath diameter, and jugular venous pressure. Near infrared spectroscopy will be used to measure lower vs. upper body local tissue hydration, and total peripheral resistance will be calculated from noninvasively acquired blood pressure and cardiac output.

It is currently unclear why only some astronauts experience vision disturbances with space flight. It is hypothesized that astronauts respond differently to the fluid shift in-flight and that this impacts changes in ocular structure and function changes. The goal of this study is to test this hypothesis. In doing so, this proposal directly addresses the Integrated Research Plan Gap Cardiovascular (CV)7: How are fluids redistributed in-flight? and Gap Vision Impairment and Intracranial Pressure (VIIP)1: What is the etiology of visual acuity and ocular structural and function changes seen in-flight and post-flight? The research proposed here will determine the effect of long duration space flight on fluid shifts and subsequent redistribution across fluid compartments and attempt to discern the contribution of these adaptations to changes in ocular structure and function.

NOTE: This study was merged with investigations from Dr. Alan Hargens (Fluid distribution before, during and after prolonged space flight) and Dr. Scott Dulchavsky (Microgravity associated compartmental equilibration) resulting in a comprehensive study titled “Fluid Shifts Before, During and After Prolonged Space Flight and Their Association with Intracranial Pressure and Visual Impairment” (short title: Fluid Shifts).

NOTE: End date is 9/30/2018 per PI (Ed., 7/8/15)

NOTE: Risk/Gap changes per IRP Rev E (Ed., 3/24/14)

In order to determine the effect of space flight on the headward fluid shift and subsequent redistribution across fluid compartments, biochemical, ultrasound, and other non-invasive cardiovascular measures will be performed before launch, during flight, and after landing. Total body water, extracellular, and intracellular fluid volume will be determined by biochemical dilution techniques. Ultrasound will be used to assess upper vs. lower body interstitial fluid and vein diameter changes, cerebral blood flow, optic nerve sheath diameter, and central venous pressure. Near infrared spectroscopy will be used to measure lower vs. upper body local tissue hydration, and total peripheral resistance will be calculated from noninvasively acquired blood pressure and cardiac output.

It is currently unclear why only some astronauts experience vision disturbances with space flight. It is hypothesized that astronauts respond differently to the fluid shift in-flight and that this impacts changes in intraocular / intracranial pressure and vision changes. The goal of this study is to test this hypothesis. In doing so, this proposal directly addresses the Integrated Research Plan Gap Cardiovascular (CV)7: How are fluids redistributed in-flight? and Gap Vision Impairment and Intracranial Pressure (VIIP)1: What is the etiology of visual acuity and ocular structural and function changes seen in-flight and post-flight? The research proposed here will determine the effect of long duration space flight on fluid shifts and subsequent redistribution across fluid compartments and attempt to discern the contribution of these adaptations to changes in intraocular / intracranial pressure and vision disturbances.

NOTE: This study was merged with investigations from Dr. Alan Hargens (Fluid distribution before, during and after prolonged space flight) and Dr. Scott Dulchavsky (Microgravity associated compartmental equilibration) resulting in a comprehensive study titled “Fluid Shifts Before, During and After Prolonged Space Flight and Their Association with Intracranial Pressure and Visual Impairment” (short title: Fluid Shifts).

Testing and training have been initiated to enable “free-floating” of the Optical Coherence Tomography (OCT) device for in-flight measurements. Prior work by members of our group tested the feasibility of using the OCT scanner in free-float (without the use of the chin rest and stage); parabolic flights were conducted in November 2013 that established that this mode was feasible. This information opened up options for scanning locations other than the Maintenance Work Area (MWA) which would include scanning in the Russian Service Module while in Chibis. An inflight free-float practice run was performed in April 2015 prior to inflight data collection in May 2015.

Three feasibility subjects were studied in the fall of 2014, allowing the Principal Investigator Team to finalize the study protocol, maximizing data collection and crew time efficiency. All training sessions and preflight baseline data collection (BDC) have been completed for both one year mission crewmembers (including one cosmonaut); training and preflight BDC has also been completed for the one year mission US backup crewmember and ground-based “TWINS” study participant. These include MRI (magnetic resonance imaging), dilution measures, ultrasound, OCT, tonometry, NIRS (near-infrared spectroscopy), CCFP (cerebral and cochlear fluid pressure), and OAE (otoacoustic emission) measures. The early inflight (FD45) testing on our first two crewmembers, including dilution measures and baseline imaging measures, were performed in the USOS segment, followed by three days of testing in the Russian segment while utilizing the Chibis lower body negative pressure (LBNP) device.

Our team attended the NASA Human Research Program (HRP) Investigators’ Workshop in Galveston, TX in January 2015, presenting a poster on the Fluid Shifts (FS) project and participating in many VIIP related sessions and discussions. We also presented a project status at the Aerospace Medical Association Annual Meeting in Orlando, FL, in May of 2015 during a VIIP panel presentation.

PI team personnel performed multiple interviews/media events for the Fluid Shifts project. In February, for Lori Meggs from Space Station Live; in March with Lorie Abadie, Chuck Lloyd and Amy Blanchett from Education and Outreach; in April with Pat Ryan from Space Station Livem; in June with Stephanie Schierholz and Julie Robinson at the Kennedy Space Center for the SpaceX CRS-7 pre-launch Tech Briefing.

NOTE: End date is 9/30/2018 per PI (Ed., 7/8/15)

NOTE: Risk/Gap changes per IRP Rev E (Ed., 3/24/14)

In order to determine the effect of space flight on the headward fluid shift and subsequent redistribution across fluid compartments, biochemical, ultrasound, and other non-invasive cardiovascular measures will be performed before launch, during flight, and after landing. Total body water, extracellular, and intracellular fluid volume will be determined by biochemical dilution techniques. Ultrasound will be used to assess upper vs. lower body interstitial fluid and vein diameter changes, cerebral blood flow, optic nerve sheath diameter, and central venous pressure. Near infrared spectroscopy will be used to measure lower vs. upper body local tissue hydration, and total peripheral resistance will be calculated from noninvasively acquired blood pressure and cardiac output.

It is currently unclear why only some astronauts experience vision disturbances with space flight. It is hypothesized that astronauts respond differently to the fluid shift in-flight and that this impacts changes in intraocular / intracranial pressure and vision changes. The goal of this study is to test this hypothesis. In doing so, this proposal directly addresses the Integrated Research Plan Gap Cardiovascular (CV)7: How are fluids redistributed in-flight? and Gap Vision Impairment and Intracranial Pressure (VIIP)1: What is the etiology of visual acuity and ocular structural and function changes seen in-flight and post-flight? The research proposed here will determine the effect of long duration space flight on fluid shifts and subsequent redistribution across fluid compartments and attempt to discern the contribution of these adaptations to changes in intraocular / intracranial pressure and vision disturbances.

NOTE: This study was merged with investigations from Dr. Alan Hargens (Fluid distribution before, during and after prolonged space flight) and Dr. Scott Dulchavsky (Microgravity associated compartmental equilibration) resulting in a comprehensive study titled “Fluid Shifts Before, During and After Prolonged Space Flight and Their Association with Intracranial Pressure and Visual Impairment” (short title: Fluid Shifts).

The first year of this project was spent merging these studies together in such a way as to maintain original specific aims from original protocols without impacting quality of science. The combined study has been approved by the Health and Human Countermeasures Element and has received Institutional Review Board approval and completed the International Space Station Medical Projects (ISSMP) feasibility assessment process. Currently, this study is under review by the Science Management Panel for Select for Flight. This study has been pitched to the one-year crew, which, if selected, will be the first crew to participate in this study.

In the second year of this project, all necessary boards approved flight status and experiment hardware was flight certified. Baseline MRI (magnetic resonance imaging) data collection was completed on the first two subjects, and L-90 preflight BDC (baseline data collection) was completed on one subject.

NOTE: Risk/Gap changes per IRP Rev E (Ed., 3/24/14)

In order to determine the effect of space flight on the headward fluid shift and subsequent redistribution across fluid compartments, biochemical, ultrasound and other non-invasive cardiovascular measures will be performed before launch, during flight and after landing. Total body water, extracellular and intracellular fluid volume will be determined by biochemical dilution techniques. Ultrasound will be used to assess upper vs. lower body interstitial fluid and vein diameter changes, cerebral blood flow, optic nerve sheath diameter and central venous pressure. Near infrared spectroscopy will be used to measure lower vs. upper body local tissue hydration, and total peripheral resistance will be calculated from noninvasively acquired blood pressure and cardiac output.

It is currently unclear why only some astronauts experience vision disturbances with space flight. It is hypothesized that astronauts respond differently to the fluid shift in-flight and that this impacts changes in intraocular / intracranial pressure and vision changes. The goal of this study is to test this hypothesis. In doing so, this proposal directly addresses the Integrated Research Plan Gap CV7: How are fluids redistributed in-flight? and Gap VIIP1: What is the etiology of visual acuity and ocular structural and function changes seen in-flight and post-flight? The research proposed here will determine the effect of long duration space flight on fluid shifts and subsequent redistribution across fluid compartments and attempt to discern the contribution of these adaptations to changes in intraocular / intracranial pressure and vision disturbances.

NOTE: This study was merged with investigations from Dr. Alan Hargens (Fluid distribution before, during and after prolonged space flight) and Dr. Scott Dulchavsky (Microgravity associated compartmental equilibration) resulting in a comprehensive study titled “Fluid Shifts Before, During and After Prolonged Space Flight and Their Association with Intracranial Pressure and Visual Impairment” (short title: Fluid Shifts).

This past year was spent merging these studies together in such a way as to maintain original specific aims from original protocols without impacting quality of science. The combined study has been approved by the Health and Human Countermeasures Element and has received Institutional Review Board approval and completed the ISSMP feasibility assessment process. Currently, this study is under review by the Science Management Panel for Select for Flight. This study has been pitched to the one-year crew, which, if selected, will be the first crew to participate in this study.

In order to determine the effect of space flight on the headward fluid shift and subsequent redistribution across fluid compartments, biochemical, ultrasound and other non-invasive cardiovascular measures will be performed before launch, during flight and after landing. Total body water, extracellular and intracellular fluid volume will be determined by biochemical dilution techniques. Ultrasound will be used to assess upper vs. lower body interstitial fluid and vein diameter changes, cerebral blood flow, optic nerve sheath diameter and central venous pressure. Near infrared spectroscopy will be used to measure lower vs. upper body local tissue hydration, and total peripheral resistance will be calculated from noninvasively acquired blood pressure and cardiac output.

It is currently unclear why only some astronauts experience vision disturbances with space flight. It is hypothesized that astronauts respond differently to the fluid shift in-flight and that this impacts changes in intraocular / intracranial pressure and vision changes. The goal of this study is to test this hypothesis. In doing so, this proposal directly addresses the Integrated Research Plan Gap CV7: How are fluids redistributed in-flight? and Gap VIIP1: What is the etiology of visual acuity and ocular structural and function changes seen in-flight and post-flight? The research proposed here will determine the effect of long duration space flight on fluid shifts and subsequent redistribution across fluid compartments and attempt to discern the contribution of these adaptations to changes in intraocular / intracranial pressure and vision disturbances.

NOTE: This study was merged with investigations from Dr. Alan Hargens (Fluid distribution before, during and after prolonged space flight) and Dr. Scott Dulchavsky (Microgravity associated compartmental equilibration) resulting in a comprehensive study titled “Fluid Shifts Before, During and After Prolonged Space Flight and Their Association with Intracranial Pressure and Visual Impairment” (short title: Fluid Shifts).