An unidentified astronaut aboard the
International Space Station had a deep vein thrombosis (DVT) — or blood clot —
in the jugular vein of their neck, according to a new case study.
The
astronaut’s identity and exactly when the incident took place are being kept
secret for privacy reasons, so identifying information was omitted from the
case study. The astronaut was two months into a six-month stay at the International Space Station (ISS) when the DVT was
discovered.
This was the
first time a blood clot was discovered in an astronaut
in space, and NASA had no established method for treating the condition in a
“zero gravity” environment.
Blood clot expert
One of the
experts brought in by NASA to treat the situation was blood clot expert Stephan
Moll, M.D., professor of medicine at the University of North Carolina (UNC)
School of Medicine at Chapel Hill. Moll was the only non-NASA physician NASA
consulted to help come up with a treatment plan for the clot, UNC officials
said in a statement.
“Moll and a
team of NASA doctors decided blood thinners would be the best course of
treatment for the astronaut. They were limited in their pharmaceutical options,
however,” because the ISS has only a small supply of medications on board, UNC officials said in the
statement.
When the clot was discovered, there
was a limited amount of the blood thinner Enoxaparin available. Moll helped
NASA determine how to ration the space station’s stock of Enoxaparin in order
to effectively treat the DVT while also making sure that the astronaut would
not run out of the drug before NASA could launch a new shipment of drugs on the
next cargo mission.
Treatment process
The astronaut’s blood clot was
treated with Enoxaparin — a drug delivered by an injection into the skin — for
about 40 days. On the 43rd day of the astronaut’s treatment, a supply of
Apixaban — a pill taken orally — arrived at the ISS on an unspecified cargo
resupply spacecraft.
The
treatment process lasted more than 90 days, and during that time the astronaut
closely monitored the blood clot by performing ultrasounds on their own neck with
guidance from a radiology team on Earth. Moll also spoke with the astronaut
through email and phone calls.
The astronaut landed safely on Earth
at the end of their six-month mission, and the blood clot required no further
treatment.
More research needed
Somewhat ironically, the DVT was
discovered when the astronaut was taking ultrasounds of their neck for a
research study on how body fluid is redistributed in zero gravity. The
astronaut had not experienced any symptoms of an abnormality. “If it wasn’t for
the study, there’s no telling what the outcome could have been,” UNC officials
said.
In the statement, Moll said there’s
a need for more research of how blood and blood clots behave in space. “Is this
something that is more common in space?” he said.
“How do you minimize risk for DVT?
Should there be more medications for it kept on the ISS? All of these questions
need answering, especially with the plan that astronauts will embark on longer
missions to the Moon and Mars,” Moll added.
Moll
co-wrote a case study on the successful treatment that was published Jan. 2 in the New England Journal of Medicine. NASA astronaut Serena Auñón-Chancellor, a medical doctor who served as a
flight engineer at the ISS for six months in 2018, during Expeditions 56 and
57, is the lead author on the study.
Story via Space.com
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