Published: Mon, January 06, 2020
Health Care | By Cedric Leonard

Doctors On Earth Remotely Treat ISS Astronaut's Blood Clot In Space

Doctors On Earth Remotely Treat ISS Astronaut's Blood Clot In Space

Both the identity of the astronaut and the timing of the mission have been kept private to protect the astronaut's privacy, but the story truly is fascinating.

Recently, an unnamed astronaut suffered what is believed to be the first blood clot in outer space.

Moll is a member of UNC's Blood Research Center and is a blood clot expert.

There was a risk of internal bleeding from an injury to someone taking blood thinners that could be hard to stop, according to the blood-clot expert.

When working with hard cases, doctors often look at the medical history to see how previous events have been handled.

"Knowing there are no emergency rooms in space, we had to weigh our options very carefully", Moll said in a UNC statement on Thursday. On the day, the astronaut landed safely and made a full recovery, but the lack of symptoms to indicate there was a clot is still of concern to Moll and the NASA medical team. "They were limited in their pharmaceutical options, however" as the medications were not sufficient on board. Once the astronaut was started on the therapy, their clot shrank, and a supply mission a month later provided the ISS with anti-clotting pills and reversal drugs just in case.

Since no more medicine would be available until the next supply mission, Moll prescribed dosages to be administered by subdermal injections over 40 days.

The astronaut took apixaban until four days before the return to the Earth.

There were also regular phone calls and emails between the patient and Dr Moll throughout the process, in an "extreme example of telemedicine".

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"When the astronaut called my home phone, my wife answered and then passed the phone to me with the comment, 'Stephan, a phone call for you from space.' That was pretty wonderful", says Moll.

Even as the astronaut was in space, he was guided in real time, and interpreted by two independent radiologists from the Earth to conduct an ultrasound, which confirmed the suspicion. "And amazingly the call connection was better than when I call my family in Germany".

Four days before the astronaut's journey home to Earth, they stopped taking Apixaban.

However, the use of blood thinners in the astronaut increases the likelihood of bleeding, and this does not seem to be a very ideal decision for someone who is not near the hospital. The NASA crew member suspended the pills shortly before returning to Earth and did not require follow-up treatment for the clot. Astronaut candidates undergo a thorough selection process and everything possible is done to make sure that they are fit for flight.

According to a new case study, the astronaut had DVT in the jugular vein of the neck.

If not for that body fluid study, however, there is no telling what could have happened.

"My first reaction when NASA reached out to me was to ask if I could visit the International Space Station to examine the patient myself", Moll said.

Despite the good news, the authors of the paper say the experience should serve as an important lesson about the many unknowns of space travel. "How do you minimize risk for DVT?"

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