What studies of altitude sickness on Everest can tell us about saving people in ICUs
The extreme conditions of climbing Mt. Everest, and the risks involved, hardly seem worth it to us regular folks who can’t even imagine voluntarily subjecting oneself to such an ordeal:
Just ahead of them, a man from another party was in trouble, staggering around and gasping for air. His body had became hypoxic and his oxygen-starved brain began to swell. His team buzzed their doctor at a camp below on a two-way radio, who reassured them that he would be OK. Grocott, an expert in high-altitude sickness, had a different opinion: it was clear to him that the man was dying. “It often happens,” says Grocott. “If you’re a doctor on a mountain, you expect to be called on to help people.”
As the light began to fade and the temperature dropped, the man’s condition worsened. Vijay Ahuja, a medical student in Grocott’s team, insisted they get involved. The stricken man’s colleagues conceded there was a problem, but it was now too dark to take him down to safety. Recognising the seriousness of the situation, one of the doctors on Grocott’s team, Dan Martin, began treatment. Martin worked through the night, managing to keep the seriously ill climber alive until dawn, when the patient’s team were able to transport him down the mountain.
But doctors are studying what’s going on here, and it can be helpful to people who would never think of ascending anything other than a small hill. That’s because there’s something about altitude sickness that’s very mysterious—it doesn’t just strike those in bad condition. In fact, it appears to strike rather randomly:
Health and fitness have no bearing on human oxygen efficiency: Xtreme Everest has taken 70-year-old civilians up the mountain with no problems, but fit, young military personnel have had to turn back. The issue is genetic, and for the last ten years Xtreme Everest has been trying to identify the specific genes concerned, which in turn might allow scientists to develop drugs that would mimic oxygen-efficient physiology. About 325,000 people are treated in ICUs in the UK each year, and Britons have a one in five chance of ending up in one at some point. Around 80,000 British people die from oxygen-related problems in ICUs every year.
In 2007, the following experiment was conducted. It was quite elaborate:
Sixty scientists, medics and researchers were recruited; 198 members of the public would trek to Base Camp, making themselves hypoxic in the process, and be tested. There would be 60-odd tests on most members of the party, with 15 climbing on to the 8,850-metre-high summit, where they would set up a lab and take the highest-altitude, lowest-oxygen blood samples in history. The simple aim: to discover the key difference between the bodies of the people who coped with the drop in oxygen and those who did not.
Results of the experiment indicated the difference was in the mitochondria. Later studies (published in 2017) of Sherpas—the people who guide expeditions, live in the area, and whose bodies have evolved over time to cope with the altitude—found something astounding:
The Sherpas were not only using oxygen to make ATP more efficiently than lowlanders, but also while the energy levels in the muscles of lowlanders drop at altitude as oxygen becomes scarcer, the energy levels in Sherpa muscles increases. “It is an extraordinary finding,” says Murray. “They need oxygen like we do, but in that low-oxygen environment, they produce not just more energy than us lowlanders, but they themselves have more energy than they do at sea level. In other words, as they climb upwards into the environment where they have adapted for thousands of years, they become healthier.
This can guide researchers who are attempting to produce drugs to help ICU patients and others with hypoxia.
I would think this kind of research could also have benefits for space exploration, maybe tilting the selection process to people who can tolerate low oxygen levels better for safety reasons.
Sherpas in Space?
I grew up in Albuquerque, NM which is 5000-6000 high, depending on where you are in town. The Sandia mountains are to the east and the Sandia tramway which starts at 6,559 feet (1,999 m) travels to Sandia crest at an elevation of 10,378 feet (3,163 m). I used to play in those mountains and the altitude never bothered me. I went to Albuquerque with my daughter to visit my mother and the altitude badly affected my daughter. She felt awful the whole week and didn’t recover till we got back to Virginia. I kept telling her “you’ll be ok tomorrow” but she never got any better. When I took my son to NM the altitude didn’t seem to bother him and we went to Sandia crest. The view is marvelous.
This has to be the only politically oriented forum that I frequent where I can learn interesting stuff like this. Thanks Neo!
Why bother to climb Mt. Everest to do this research? It’s not all that scenic, but decompression chambers are relatively common around most Air Force bases. I’ve even simulated an “explosive decompression” where we replicated the experience of a blowout at 35,000 feet altitude; most aviators have.
The advantage, of course, is that if somebody can’t handle altitude, he can cycle through the airlock and be back at sea level pressure in 10 minutes.
This “news” article is fanciful, hyperbolic and full of unproven and unprovable allegations such as “the man’s brain was swelling”. They did exactly what to keep him alive overnight? “Worked through the night”, doing what? Feeding him furosemide pills? Nothing said. No burr holes placed, apparently. They just “worked”, undefined.
There is also the fanciful assertion that Sherpas handle oxygen “more efficiently”.Well, yes, they’ve physiologically been long adapted to living at altitude; same thing occurs in Bolivia! Higher red blood cell mass for greater O2 transport. No magic, no special endowment, at least not apparent to me in this article. No, I am not going to research the topic on-line! But I suspect the subtle underlying hero is skin color, since Sherpas are brown Asians and it’s the white man who struggles to ascend, not the Sherpa.
Plus useless speculations about mitochondrial function differentials because someone told the writer ATP was produced therein, a molecule probably described as THE source of energy. Writer probably does not know what ATP stands for, how it is created, what it does. Thanks to the Krebs cycle, of which the writer has doubtless never heard, but which is a true miracle of human biochemical discovery.
This is a piece of journalism, not of science. As such, it is fish wrap.
Ken Mitchell Says:
March 16th, 2018 at 7:41 pm
Why bother to climb Mt. Everest to do this research? It’s not all that scenic, but decompression chambers are relatively common around most Air Force bases
* * *
That’s no fun.
Frog — thanks!
You reminded me of Michael Crichton’s Gell-mann Amnesia Effect.
Doing research on a mountain or underground on test subjects also includes in the parameters the cirrcadian cycle, present in the cryptocells behind our eyes.
If one wanted to isolate the variables down, then artificial de-compression chambers provide more isolated results. The experiments would be limited to only those variables however.
The article noted that there was a concern with costs. Plus unless those chambers are the size of the Deep UnderGround Military bases such as Cheyenne Mountain, it will be hard to accommodate enough individuals at once to ensure there are no unintended contamination of the data.
His body had became hypoxic and his oxygen-starved brain began to swell.
I went up 1-2 miles on a local mountain. It wasn’t so bad, even though I don’t usually exercise outdoors. One of the other hikers in my group was even more unused to it, apparently, and seemed to suffer from lack of oxygen. I was utilizing a significant amount of lower abdominal breathing. By demonstrating the maximum level of that technique, I think I might have put too much oxygen into my blood streams.
Generally the legs require substantial oxygen when climbing up, which can pull blood oxygen from the brain. The brain soaks up a lot of blood oxygen in the process and limitations may be affected if the body decides the legs are more important. Besides, it’s hard to circulate and recalculate the blood balance without certain breathing techniques to artificially and manually cycle the blood throughout the cells.
The Far East has an interesting name for breathing techniques that forcibly remove toxins from bone, marrow, and flesh. It was derived from a Buddhist traveling monk that founded the Chinese Shaolin Buddhist temple, that came from India. He was carrying an ancient secretive technique called the Bone Marrow washing technique, which sounds rather cryptic but is easily integrated by Western practitioners.
Jesus was not the first nor the last to come across ancient physical and spiritual cultivation methods that boosted one’s capabilities.
This is a piece of journalism, not of science. As such, it is fish wrap.
There’s the popular presentation of science and then there’s the dark hidden underside of what’s really going on in peer review.
https://www.counterpunch.org/2013/12/13/the-peer-review-hypocrisy/
Then, a confession, and a pledge. “Like many successful researchers, I have published in the big brands, including the papers that won me the Nobel Prize for medicine, which I will be honoured to collect tomorrow. But no longer. I have now committed my lab to avoiding luxury journals, and I encourage others to do likewise.” The pointed suggestion here is that such luxury journals damage science the way the banksters have damaged finance and banking.
These gripes are standard and hard to fault. Nature, Science and Cell have popular pitches, claiming to drive the pioneer’s vehicle into uncharted waters. That said, the dirt under the nails is not regarded as important. Glamour is what wins over, chic science, the sort that makes a splash. Editorial inclinations feed author expectations — a vicious cycle is thereby created
Historically I find it interesting that revolutionary successes that have pushed the boundaries of human limits have almost always been performed by the feats of a single person: usually called crazy, insane, or ostracized. We were told, presumably, that Western success was built on the shoulders of giants. What they didn’t tell us was how so many of the “peers” of those giants didn’t appreciate the work at the time, given the competition. Why is it like that, one might ask; are not scientists our new heroes and Western superstars plus priests?
Because they are human and much akin to the other trash produced by humans.
For those interested in more background and research on this topic, use the search phrase “Ridiculed science mavericks vindicated” from amasci dot com.
It would be so much easier for this Ymar to trust in Western priests claiming to be the scientific authority if I hadn’t learned all the hidden underlining events and forces at work. They don’t tell the public this because honestly the public can’t handle the truth. Nor have people earnestly wished and desired for the truth to set them free. Slavery is preferred over anything that unsettles the popular scientific consensus.
“What excites me is that we are witnessing human evolution here,” Murray continues, “It’s happened over thousands of years, but that’s quite recent in a human time frame. And it’s associated with gains in performance.”
That’s a natural conclusion for a secular scientist to jump to. Wrong, but natural.
Notice how Murray conflates his research results on the Sherpa’s DNA traits, as being equivalent to Darwin’s micro or modern macro evolution ideas. Scientists are human thus they have pet theories and presuppositions they don’t know that they have.
And the biology of metabolism is highly complex
Wait until they figure out sunlight and EM fields effect on human metabolism. They won’t know what hit them.
AesopFan Says:
March 16th, 2018 at 4:02 pm
I would think this kind of research could also have benefits for space exploration
Ever see the permed hair videos of the ISS NASA astros on youtube?
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Lots of fun.
makes sense. I have heart failure and for a time my EF was down to 12%… and I kept my full time job where I have to walk around all day. So; yeah.. Some people can handle oxygen transport more efficiently than others..
“lowlanders?”
Them lowlanders have been up here again.
There is a remarkable deficit in physiologic knowledge demonstrated in some comments here.
Example: Ymar’s “I was utilizing a significant amount of lower abdominal breathing. By demonstrating the maximum level of that technique, I think I might have put too much oxygen [sic] into my blood streams.” [not how it works, Ymar!!]
“Generally the legs require substantial oxygen when climbing up, which can pull blood oxygen from the brain. The brain soaks up a lot of blood oxygen in the process [really?] and limitations may be affected if the body decides the legs are more important.” Ymar seems to believe the “Body” works like a CEO, allocating resources (O2 in this case) among organs, even in error. The implication is hikers become stupid due to O2 starvation of the brain in favor of legs. What is the “Body”, Ymar? Ever hear of anaerobic metabolism and its production of lactic acid?
“thomass” ‘ understanding of cardiac function is remarkably limited in its expression here. It’s pretty tough to exercise, putting a higher demand on a heart that cannot deliver. It is called congestive heart failure (CHF) for a reason: failure! Maybe medicines had something beneficial to do with supporting your walking around?
Frog;
spare me. For someone criticizing a deficit of knowledge your not paying attention or adding anything to the conversation. We are not talking about exercise adding to efficiency. We were talking about evolution and theories about some people possibly having a genetic based greater efficiency in the mitochondria that can compensate for oxygen deficit.
As to medication, they are to help remodel the heart… to improve EF. If EF is 12%, in part due to just starting medication or failure to respond to medication… EF is 12%. You have a serious problem with a 12% EF. For many that means an inability to do very much. Medication will NOT improve your ability to walk around (it may help your heart function long term; but you won’t get a boost just taking it). Some lower your blood pressure (as a side effect… so it might not be helping your energy level if it is dropping it very low), increase fatigue, et cetera… and probably add to the difficulty of working (while adding the possibility of improvement down the line).
The fact that I could maintain a semi normal life probably did have something to do with greater efficiency… somewhere else in the system…
thomass: Sorry, but “greater efficiency” in mitochondria remains speculation, an unproven theory. Which goes to re-emphasize my fundamental point: you need to really really know physiology and pathology before you can engage in reasoned speculation on those subjects.
The fact that you could (can you still?) engage in a “semi-normal life” is a tribute to the skill and knowledge of the docs who cared for you. They did not treat you with speculation.
I have added knowledge to the conversation. That you don’t like it does not matter. Facts are facts.