. 2023 Feb 16;9:17. doi: 10.1038/s41526-023-00260-9

Table 3.

Prevention—Gap Analysis and Recommendations.

Gap	Recommendation
We do not know which measures could be taken to prevent VT in space. We do not know the adverse effects of potential countermeasures.	1. Assess the role of countermeasures and potential adverse effects of those countermeasures for prevention of VT, including: a. LBNP in VT prevention during space travel and in ground-based analogues³⁶ b. Assess effectiveness of whole-body vibration (WBV) and RVE interventions to prevent VT during spaceflight and in ground-based analogues c. Assess role of anticoagulant and antiplatelet therapy for VT prevention during spaceflight and in ground-based analogues d. Assess the role of nitric oxide (NO) precursors (nitrites and nitrates) as a way to increase NO bioavailability, induce vasodilation, and prevent inappropriate aggregation / coagulation. e. Assess role of mechanical measures (e.g., compression stockings) to reduce stasis during spaceflight and in ground-based analogues f. Assess the role of exercise (type of exercise, intensity, duration, time of the day) as a way to increase prevent muscle atrophy (and the associated decreased muscle pump), induce shear stress, improve endothelial function, prevent venous stasis, inappropriate aggregation and coagulation.

Gap

Recommendation

We do not know which measures could be taken to prevent VT in space.

We do not know the adverse effects of potential countermeasures.

1. Assess the role of countermeasures and potential adverse effects of those countermeasures for prevention of VT, including:

a. LBNP in VT prevention during space travel and in ground-based analogues³⁶

b. Assess effectiveness of whole-body vibration (WBV) and RVE interventions to prevent VT during spaceflight and in ground-based analogues

c. Assess role of anticoagulant and antiplatelet therapy for VT prevention during spaceflight and in ground-based analogues

d. Assess the role of nitric oxide (NO) precursors (nitrites and nitrates) as a way to increase NO bioavailability, induce vasodilation, and prevent inappropriate aggregation / coagulation.

e. Assess role of mechanical measures (e.g., compression stockings) to reduce stasis during spaceflight and in ground-based analogues

f. Assess the role of exercise (type of exercise, intensity, duration, time of the day) as a way to increase prevent muscle atrophy (and the associated decreased muscle pump), induce shear stress, improve endothelial function, prevent venous stasis, inappropriate aggregation and coagulation.