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Abstract：
INTRODUCTION: A review of decompression sickness (DCS) cases associated with the NASA altitude physiological training (APT) program at the Johnson Space Center (JSC) motivated us to place our findings into the larger context of DCS prevalence from other APT centers.METHODS: We reviewed JSC records from 1999 to 2016 and 14 publications from 1968 to 2004 about DCS prevalence in other APT programs. We performed a meta-analysis of 15 APT profiles (488 cases / 385,116 exposures). We used meta-regression to evaluate the relation between estimated exposures and probability of DCS in a test group, accounting for the heterogeneity between studies.RESULTS: Our in-house review identified 6 Type I DCS (1 from an inside observer) and 1 Type II DCS. There were 6 cases in 9560 student hypobaric exposures from 3 NASA training flights; a student pooled prevalence rate of 0.44 cases / 1000 exposures compared to 1.44 cases / 1000 from 12 published APT profiles. The overall pooled DCS prevalence rate was 1.16 cases / 1000 exposures. There was substantial heterogeneity in DCS prevalence across studies. Denitrogenation time, exposure pressure, and exposure time were associated with probability of DCS in the meta-regression model.CONCLUSIONS: While the overall DCS prevalence rate is relatively low, there is marked heterogeneity among profiles. The pooled DCS prevalence rate estimate for the NASA profiles was lower than the overall rate. Variability in APT profile DCS prevalence could be further explained given student level and additional test-level covariates.Conkin J, Sanders RW, Koslovsky MD, Wear ML, Kozminski AG, Abercromby AFJ. A systematic review and meta-analysis of decompression sickness in altitude physiological training. Aerosp Med Hum Perform. 2018; 89(11):941-951.
摘要：
简介：与约翰逊航天中心（JSC）的NASA高原生理训练（APT）计划相关的减压病（DCS）病例的回顾促使我们将我们的发现置于其他APT中心的DCS患病率的更大背景下。方法：我们回顾了1999年至2016年的JSC记录和1968年至2004年关于其他APT计划中DCS患病率的14篇出版物。我们对15个APT概况(488例/385,116次暴露)进行了荟萃分析。我们使用元回归来评估测试组中估计暴露量与DCS概率之间的关系，考虑研究之间的异质性。结果：我们的内部审查确定了6个I型DCS（1个来自内部观察者）和1个II型DCS。在3次NASA训练飞行中，9560名学生的低压暴露中有6例；学生的合并患病率为0.44例/1000例，而在12个已发布的APT概况中，学生的合并患病率为1.44例/1000。总体汇集的DCS患病率为1.16例/1000暴露。研究中DCS患病率存在显著异质性。脱氮时间,暴露压力,在meta回归模型中，暴露时间与DCS的概率相关。结论：虽然DCS的总体患病率相对较低，配置文件之间存在明显的异质性。NASA配置文件的合并DCS患病率估计值低于总体患病率。考虑到学生水平和其他测试水平协变量，可以进一步解释APT概况DCS患病率的变异性。ConkinJ,桑德斯RW,科斯洛夫斯基医学博士,磨损ML,KozminskiAG,AbercrombyAFJ.高原生理训练中减压病的系统评价和荟萃分析。AerospMed嗡嗡声表演。2018年；89（11）：941–951。
