Automatic cardiac massage for astronauts

Space medicine: doctors and researchers from Nancy test an automatic cardiac massage for astronauts.

A team of researchers from Nancy is currently working on the feasibility of cardiac massage in weightlessness. Real-life experiments will take place from March 25 to 29 at Bordeaux airport, in conjunction with CNES (Centre National d’Études Spatiales).

Why test emergency medical protocols in the space environment?

In the coming years, the main international space agencies are planning ambitious space projects with long mission durations, unprecedented for manned flights until now, and exposed to new risks. Against this backdrop, it would appear necessary to plan, codify and optimize emergency medical protocols to deal with any acute medical situation in the difficult, isolated environment of a spacecraft.
In the event of cardiac arrest, survival depends essentially on cardiac massage, which must be initiated quickly and effectively to ensure the best possible prognosis. Terrestrial methods, which rely on the weight of the operator to deliver the appropriate thoracic compression force, are unsuitable for application during space missions, as the weightlessness of space makes the rescuer’s weight zero. Alternative manual methods have thus been developed, but their effectiveness remains sub-optimal when compared with the quality criteria of the leading resuscitation societies.

A multidisciplinary project team

It was against this backdrop that Nathan Reynettea medical student in Nancy, and Dr. Mickael Lescroartan intensive care physician at Nancy’s CHRU (University Hospital Centre), set out to tackle the problem in 2021. They were soon joined and supported by Professor Bruno Chenuel, a sports physician and professor of physiology and aeronautical medicine in the DevAH UR3450 laboratory at the University of Lorraine, and began by reviewing the literature and contacting NASA’s ISS medical officer about cardiac arrest during a space mission.

Improvements to current protocols

This collaboration has resulted in the publication of a scientific article in the Journal of the American Society of Aerospace Medicine, in which several improvements to current protocols are proposed, based on recent recommendations for resuscitation on Earth, including the use of automatic cardiac massage machines. These machines are commonly used on Earth and have been scientifically validated, particularly for resuscitation in difficult environments (eg helicopter or EMS ambulance), but only one non-comparative study has tested the concept in microgravity, which is insufficient scientific evidence for use in real -life conditions.

Parabolic flight in an Airbus A310

The Nancy-based team therefore needed to provide experimental proof of the effectiveness of these machines: to this end, they applied to the Center National d’Études Spatiales (CNES) call for projects to test the experiment during a parabolic flight. The CNES parabolic flights are designed to recreate weightlessness in a modified Airbus A310, which performs repeated free-falls. To carry out this experiment, the team has grown with the participation of Luc Sagnièresa 6th year medical student in Paris and doctor in mechanical engineering, Baptiste Sandoz engineer doctor in Human Biomechanics at ENSAM in Paris, Dr Benjamin Pequignotintensive care physician in Nancy, Professor Stéphane Zuily vascular physician and medical director of the CUESIM1 located at the Faculty of Medicine, Maieutics and Health Professions in Nancy, and Professor Bruno Levy head of the medical intensive care department at the Nancy CHRU.

A multidisciplinary collaboration

With the project approved in 2023, the team is currently conceptualizing the experimental protocol. The study will be a multimodal evaluation, based on a multidisciplinary collaboration. In addition to measuring the medical efficacy of three machines compared with the manual reference method, Baptiste Sandoz is providing a technical assessment to measure the impact of using the machines on the structural integrity of a spacecraft, while Professor Zuily and the CUESIM team, specialists in medical learning through simulation, are bringing a pedagogical perspective to the problem by proposing to create and evaluate a training protocol for astronauts in the use of cardiac massage machines.

The experiments will take place from March 25 to 29, 2024, with NOVESPACE, a CNES subsidiary, at Bordeaux Mérignac airport.