Everest explorers celebrate landmark 

18/06/2012 00:00 

Explorers marked the fifth anniversary of a journey to the summit of Everest which could change the way patients are treated in intensive care units across the world.
From l to r: Professor Mike Grocott; Dr Richard Moon, Professor of Anesthesiology at Duke University in South Carolina, and Prof

From l to r: Professor Mike Grocott; Dr Richard Moon, Professor of Anesthesiology at Duke University in South Carolina, and Professor Monty Mythen

Summiteers, sherpas, scientists and clinicians involved in the Caudwell Xtreme Everest expedition gathered at the UCL Institute of Child Health to hear about what was learnt from the trip in 2007 and subsequent expeditions.
Back in May 2007 clinicians – including a number from UCLH - scientists and sherpas totalling 260 took part in the largest ever medical research expedition to altitude. They made the arduous trek up 18,000ft to Everest base camp undergoing rigorous tests at a series of camps along the way. Eight others continued on to summit.
Their mission was to investigate hypoxia, low oxygen levels found in healthy climbers at altitude, and bring benefits to the bedside of patients with low levels of oxygen in intensive care.
By coincidence, the summit of Everest is exactly at the limit of human tolerance for hypoxia. Understanding how and why people adapt differently to low oxygen levels when they are critically ill may lead to new treatments.
Benefits might arise not just for intensive care patients but those with conditions ranging from cystic fibrosis, acute respiratory distress syndrome (ARDS), emphysema, septic shock and blue babies.
Since the trek the team involved have been analysing the data and presenting the findings around the world. Over 20 articles have been published in scientific journals based on the data, including an article in the New England Journal of Medicine.
Just days before this month’s reunion, seven of the expedition group returned to Kathmandu to honour a promise to medics in Nepal that they would share the results of their research with them.
Professor Monty Mythen, consultant in anaesthesia and critical care and director of research and development at UCLH, was part of the group which returned to Nepal.
He said: “It is the first time that a group has returned to Nepal to honour an agreement like the one we made.

From l to r: Dr Ned Gilbert, Dr Dan Martin and Kay Mitchell discussing the Xtreme Everest 2 plans in the Everest Bakery at Namch
From l to r: Dr Ned Gilbert, Dr Dan Martin and Kay Mitchell discussing the Xtreme Everest 2 plans in the Everest Bakery at Namche Bazaar

“One of the unifying theories that came out of the expedition is this idea of Everest in utero. When you grow in the womb, the level of oxygen you experience is almost the same as you experience on the summit of Everest. That means we have been there before. 
"After you are born something changes in how rapidly you can adapt to that level again. Some people can walk to the summit without needing to adapt. For others it takes much longer. If we can understand our rate of adaptation we can establish the best way to treat them in intensive care. If patients are coping with low levels of oxygen we don’t have to put them on a ventilator which we know can cause harm.”
Kay Mitchell, acting managing director for the Centre for Nurse and Midwife-led Research, was among the party which returned to Nepal to present their findings. She stayed on to return to Namche Bazaar and spoke at the reunion via a live link.
She said: “It was wonderful to return to Nepal and catch up with the medics, Sherpas and other Nepalis that supported our research in 2007. We would not have been able to achieve any of this without them. It also gave us the chance to discuss our ongoing plans for our expedition in 2013 - Xtreme Everest 2."
The Xtreme Everest research programme has now expanded into an international collaboration between UCL, University of Southampton and Duke University Medical Centre in North Carolina, USA.

Speaking at the anniversary meeting, Mike Grocott, leader of the 2007 study and Professor of Anaesthesia and Critical Care Medicine at the University of Southampton said " We are very excited to be starting studies in patients to evaluate some of the treatments and tests that have been developed out of the 2007 expedition.
"These clinical studies will progress in parallel with studies in low-pressure chambers with our american colleagues at Duke and the Xtreme Everest 2 study in Nepal next year." 
The Xtreme Everest 2 study in 2013 will be led by Dr Dan Martin, a senior lecturer in Critical Care at UCL and consultant at the Royal Free Hospital.


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