Breathing new life into medical research

Three Irish doctors are set to scale Mount Everest as part of a medical research team, writes Lorna Siggins

Three Irish doctors are set to scale Mount Everest as part of a medical research team, writes Lorna Siggins

The summit of Mount Everest may seem like the most remote place on the planet for a child with cystic fibrosis. However, three Irish climbers are among a 10-strong medical research team aiming to use their experience on the world's highest summit to improve the care of the critically ill.

Dublin-based doctors Roger McMorrow (31) and Michael O'Dwyer (31) and Dr Nigel Hart (40) from Belfast are setting off for Nepal on St Patrick's Day, with an international expedition led by British doctor Dr Mike Grocott.

The Caudwell Xtreme Everest medical study aims to take an arterial blood sample from the leg of one of their group on the 8,850-metre summit, and to undertake muscle biopsies during the ascent, as part of an extensive programme of research into hypoxia or low oxygen levels.

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Everest, which has been climbed by 10 Irish people to date, tends to be synonymous with both human achievement and human failing.

Ethical concerns about commercialisation and mountain "tourism" are the subjects of constant debate on climbers' websites.

That so little medical research for the benefit of others has been carried out in the extreme environment tends to tell its own story.

"No one knows how low oxygen levels in the blood drop on Everest," McMorrow, a past president of Queen's University Belfast (QUB) mountaineering club, told The Irish Times.

As part of a detailed programme of blood analysis during the expedition, the climbers will build a laboratory at 7,000 metres (22,966ft) on the Western Cwm (the valley of silence).

A double-skinned tent, with a solid floor and generator, will be fitted with medical equipment including exercise bikes.

The expedition is non-commercial, unguided, and all of the medics have climbed to 8,000 metres before. They chose the 8,201-metre Himalayan peak, Cho Oyu, to undertake a dry run of their research programme.

Two of the group - comprising seven anaesthetists, one vascular surgeon and two general practitioners (GPs) - will test a new closed circuit breathing system which McMorrow designed to improve the efficiency of oxygen delivery to the lungs.

At 8,000-metre altitudes, there is less than half the amount of oxygen than at sea level.

"This is where intensive care patients come in, because they are climbing their own Everest every day," McMorrow says.

As he explains, there are two types of supplementary oxygen systems used by patients in hospital, and by people at home with cystic fibrosis and chronic lung disease.

The open circuit system "blows across the face and is very inefficient", he says, while the closed circuit system, similar to rebreathers used by divers, "tends to be a lot heavier and has moving parts".

"I've removed a lot of the complexity from the closed circuit system and tried to make it lighter.

"The air is recycled: exhaled carbon dioxide is removed and the remaining oxygen re-used. It gives a better mix of gases, less oxygen is wasted and the system is portable, which allows people some freedom.

"That freedom is the critical part," he continues.

"Patients on supplementary oxygen at home are either tied to a large cylinder or are carrying a small cylinder which doesn't give oxygen for very long.

"This means they can't exercise, which then increases their dependency on oxygen."

McMorrow believes his device may allow a mountaineer to "run on the South Col", and the group hopes to slash the estimated time of a 20-hour round trip, from Camp 4 to the summit, to between five and six hours.

McMorrow grew up in the Mournes and was inspired by climbers such as Belfastman Dawson Stelfox, who became the first Irishman to climb Everest - in May, 1993.

McMorrow and his wife, Sara Spencer, also a climber, have travelled extensively and he is now a trainee anaesthetist based in Dublin.

O'Dwyer is originally from Clonmel, Co Tipperary, while Hart is also a QUB graduate climber.

The expedition comprises 57 people in total, as a number of scientists and support staff will work with 200 trekkers, also participating in the venture.

The trekkers will be examined at sea level and in three laboratories, set up by the team in Nepal, including one at base camp. Among the trekkers from Europe, North America and Australia is entrepreneur John Caudwell, main sponsor and founder of the Caudwell Charity.

The project has been co-ordinated by the Centre for Altitude, Space and Extreme Environment Medicine (Case) medicine at University College, London.

BBC's Horizon and the Discovery channel will be documenting the adventure, and it has been endorsed by Dawson Stelfox, who applauds the mountaineers' "determinal and skill", and by Michael Power, president of the Intensive Care Society of Ireland.

Northern Irish climber Gavin Bate will also be on the mountain this season, undertaking a traverse of Everest between Nepal and Tibet which will raise funds for the west of Ireland cardiology foundation, Croí.

Bate has already attempted Everest on three occasions, without oxygen and minimal support.

Significantly, this year marks the 100th anniversary of the use of supplementary oxygen by mountaineers.