Table 1 Constraints to medical care delivery during a space exploration mission and the simulation setting at MDRS. Adapted from Marshburn and Norfleet [17, 36]
Feature of an actual space exploration mission | Constraint replicated at MDRS? |
|---|---|
Physiological changes | |
 Physiological alterations induced by the space environment: space motion sickness, muscular and bone loss, orthostatic hypotension upon return to gravity, loss of aerobic capacity, immunodeficiency | Partially (cardiovascular deconditioning only) |
 Poor expected hemodynamic tolerance to hypovolemia, general anaesthesia, mechanical ventilation | Yes |
 Pharmacodynamics and pharmacokinetics changes | Partially (drugs distribution affected by lower cardiac output) |
 Reduced wound healing | No |
Technical constraints | |
 Isolation and impossible urgent evacuation | Yes |
 Communication delay | Yes |
 Immobilisation of patient, operator and equipment (in weightlessness) | Not applicable |
 Limited medical equipment and consumables (mass, volume, power requirement) | Yes |
 Limited choice and volume of IV fluids | Yes |
 Specific IV fluid infusion system (in weightlessness) | Not applicable |
 Altered drugs shelf-life | No |
 Risk of closed environment contamination with gas, liquids or biological substances | No |
 Lack of blood substitutes | Yes |
 Management of healthcare waste | Yes |
Human factors | |
 Limited medical skills (especially if crew doctor injured or ill) | Yes |
 Fading of skills during the flight | No |
 Psychological stress | Partially |