Managing Select Medical Emergencies During Long-Duration Space Missions

Abstract

INTRODUCTION: Space agencies and private industries worldwide are planning long-duration missions, which come with complex medical challenges. Crews must be prepared for medical emergencies due to longer mission durations, increased travel distance, communication delays, and higher levels of isolation. This study aimed to systematically review the existing literature and knowledge gaps that could be related to the management of medical emergencies during long-duration space missions. METHODS: A scoping review was conducted following the PRISMA extension for scoping reviews. Electronic databases, including ARC, Embase, IEEE Xplore, Medline Ovid, PsycINFO, and Web of Science, were searched from inception to June 1, 2023. Empirical study designs published in English or French were eligible for inclusion provided they described the management of at least 1 of 10 prioritized potentially mission-critical medical conditions. RESULTS: A total of 484 full-text studies were assessed for eligibility, with 99 included in this review. Conditions with the highest representation were spaceflight-associated neuro-ocular syndrome (N = 23), herniated disk (N = 22), and nephrolithiasis (N = 22). Conditions with the least representation were cerebrovascular accidents (N = 4), eye penetration (N = 3), and retinal detachment (N = 2). The duration of missions varied between 5 and 438 d for studies conducted in space. The data reflected the scarcity of evidence concerning prolonged deep-space exposure beyond the Earth’s magnetosphere. DISCUSSION: Substantial medical autonomy is essential for the success of long-duration space missions, when medical support and even communication will be limited. Future research should prioritize knowledge gaps to improve preparedness and medical autonomy for space exploration activities.