Caudwell Xtreme Everest

The statistics are frightening - 1 in 6 of us will spend time in an Intensive Care Unit during our lives. This has nothing to do with genetics, unhealthy living or financial status - it can happen to any one of us. 30% of those admitted will not survive, cutting short promising futures and devastating families.

Dr. Mike Grocott noticed that his Intensive Care patients shared something in common with high altitude mountaineers, their bodies both struggled with the lack of oxygen. In 2007, he led a team of doctors to climb Mount Everest in an attempt to solve a long-standing puzzle:

“How can mountaineers survive on oxygen levels so low that they would take the lives of intensive care patients in a matter of minutes?”

On the summit of Everest, there’s so little oxygen getting into the lungs that the body quickly starts shutting down and mountaineers risk slipping into a coma. But those extreme conditions mimicked what it’s like for patients in intensive care and studying the human body in that environment will teach us important lessons in the science of survival.

By pushing themselves to the limit of human endurance and in the most testing conditions, the Caudwell Xtreme Everest team hope that the experiments they performed will lead to better treatment for the critically ill. Put simply, they risked their lives to save lives.

Overall aims were prioritized as safety first, science second, and climbing third:
Safety – Science - Summit

This was the largest ever medical research expedition at high-altitude and Max Adventure were responsible for:

• Equipment sponsorship, testing and training.
  
• Expedition logistics from set-up to pack-down.
  
• Building and decommissioning the permanent laboratories and all power supplies.
  
• Communications with VHF and satellite systems.
  
• Base Camp management
  
• Equipment maintenance and repair.

In total 120,000 items, making up 26 tons of equipment were shipped from the UK to Nepal and dispatched to the appropriate laboratory location. In total: 500 expedition barrels, 250 toughened cases and 100 purpose-built containers were used; along with 100 compressed gas cylinders for investigation and medical purposes and 26 generators and 60 car batteries for power. A Sherpa team, helicopter contractors and yak drivers with over 200 yaks were used to coordinate transport of all equipment.

All equipment was delivered to the appropriate location, on or ahead of schedule and no equipment was lost.

The team carried out various tests in both altitude and cold chambers (9,000 meters and -30C) in the UK, and embarked on field trials in the Alps and on the mountain of Cho Oyu, Tibet (8,000 meters) in 2005 and 2006. Media interest in the project was high, with the Horizon series being commissioned to produce documentaries for the BBC and Discovery Channel in addition to BBC News covering the expedition for worldwide distribution.

To assist the doctors with these studies and allow them to produce a wide cross-section of results, 198 volunteers formed the Trekking Team and were tested first in London and then as they made their way to Base Camp. In addition to this, a further 500 volunteers were tested in London (sea level) to give a ‘base’ from which the results could be compared.

In Nepal, 7 laboratories were established on the expedition:

• Kathmandu - 1300 meters
  
• Namche Bazaar - 3500 meters
  
• Pheriche - 4200 meters
  
• Everest Base Camp - 5300 metres
  
• Camp 2 in the Western Cwm - 6400 meters
  
• Camp 4 on the South Col 7950 meters

A small shelter was briefly erected at 8400 meters during the summit climb in order to provide a protected environment for the highest blood gas measurements.

Normally, climbing teams just concentrate on getting to the top, but this expedition was different, with fixed laboratories being in place for over 10 weeks.

The Kathmandu laboratory was situated in a large hotel room and was staffed by 8 investigators and two hospitality staff. The Namche laboratory was situated in several small rooms within a trekking lodge and was staffed by 8 investigators. The Pheriche laboratory was situated within 2 small rooms within a trekking lodge and was staffed by 3 investigators. The EBC laboratory was situated in 3 Deployable Rapid Assembly Shelters (DRASH) and was staffed by 13 investigators. An additional large DRASH was divided and used as a medical centre and logistics power unit. The laboratory at Camp 2 was situated within a small DRASH and was staffed by the climbing investigators, as was the laboratory on the South Col which was housed within an 8-person high altitude tent.

240 volt mains type electricity were provided at all laboratories up to and including Camp 2 using a combination of Honda petrol generators and solar panels linked to Exide batteries by combined inverter/charger and uninterruptable power supply units. The South Col laboratory utilized a 24-volt direct current electricity supply. Although mains electricity was available in Kathmandu, we used an uninterruptable power supply system with backup battery and generator system in addition to assure reliability of supply.

The volume of data generated by the study of over 200 subjects was large and presented significant challenges. More than 4500 diary days of data were obtained from the daily collection of tests on all subjects, more than 1800 exercise tests were completed and analyzed and there are more than 10,000 plasma samples, stored in liquid nitrogen containers.

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