RESUMO
The present review aimed to suggest approaches to prospective medical problems related to the health maintenance of space crews during future manned interplanetary, particularly Martian, missions up to 2-3 years with a possible stay on a planet with gravity different from that on Earth. The approaches are based on knowledge so far obtained from our analysis of the medical support of long-term orbital flights up to one year, as well as on the consideration of specific conditions of interplanetary missions. These specific conditions include not only long-term exposure to microgravity, but also a prolonged stay of unpredictable duration (2-3 years) on board a spacecraft or on a planet without direct contact with Earth, and living in a team with a risk of psychological incompatibility and the impossibility of an urgent return to Earth. These conditions necessitate a highly trained medical person in the crew, diagnostic tools and equipment, psychophysiological support, countermeasures, as well as the means for urgent, including surgical, treatment on board a spacecraft or on a planet. In this review, the discussion was focused on the following predictable medical problems during an interplanetary mission; 1) unfavorable effects of prolonged exposure to microgravity, 2) specific problems related to Martian missions, 3) medical monitoring, 4) countermeasures, 5) psychophysiological support and 6) the medical care system.