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Xtreme Everest 2 is building on our previous experiment.
And what we're looking at is the staged ascent to altitude,
as the air gets thinner and thinner, trying to understand
how humans adapt to the low levels of oxygen that we're
experiencing at altitude.
The expedition is a huge research project and we've set
up a number of laboratories to test volunteers at they ascend
higher and higher up the mountain to Everest base camp,
where we are here.
When we were here initially, the temperatures at night were
dropping to almost minus 30, which is quite
difficult to sleep in.
And when you get up in the morning it's
still minus 10 or so.
The investigative team is very cold, as is all the equipment.
So it's a hard, hard life.
Not only is it an absolutely brutal environment, you're
pushing towards the so-called death zone.
It's very, very hard to live there both from the oxygen
availability, and the temperature.
You're living in tents on broken ground and moving ice.
So absolute heroes of this whole endeavour, alongside the
volunteers who are being tested, are the researchers
who lived there for three months.
This place is nuts.
So where we are now, 5,300 metres above sea level, and
there's approximately 50% of the oxygen in the atmosphere
that you're breathing, than we will find at sea level.
We will work in places where patients are short of oxygen
for diseases of the lungs or hearts, or other parts of the
body mean there's less oxygen available for the organs.
And some people couple with that and some people don't.
If we look at a group of, let's say, 100 people admitted
with a pneumonia, you treat them in exactly the same way
and about 25% shake it off straightaway
within a week or so.
There's about 50% that we need to bring into hospital and it
takes them a month or so to get better.
Just another 25% that crash and burn within a week.
And they die as a result of exactly the same pneumonia.
Now, a fundamental difference between those is how quickly
they can adapt to the lack of oxygen.
And that's exactly the same sort of thing we see up here.
25% don't notice it, 50% find it difficult, 25% find it
really hard.
We have very strong evidence now to say they're exactly the
same mechanisms.
And if we can understand that, we can come up with different
treatments, and possibly even different drugs that will move
everyone into that rapid adapting group, and therefore
increase survival.
One of the striking things is how tolerant the Sherpa people
are of the low levels of oxygen.
You look at them, they don't look like incredibly
physically fit athletes.
But when you see their performance--
their ability to carry high loads, their ability to work
when we're suffering, even when we're acclimatised--
it makes you ask the question, why are they so different?
Now, there's been numerous experiments in the past on
Sherpas, and classical physiology tells us that they
are no different.
But now we have questions that couldn't be asked before.
It's something going on at a cellular level, right down in
the tissues, in the muscles.
And within there it's the fuel cells, they're called the
mitochondria, where the oxygen is used.
And that's what we're exploring in
great detail this time.
The three important things that we're looking at are the
micro circulation, the mitochondria, and nitric
oxide, which may control those two, are very relevant to the
kind of things that we see in our intensive care patients.
And it may be that we need to shift the way in which we
treat intensive care patients based on what we find here.
One of the big parts of Xtreme Everest 2 is looking at
nitrates, which are little chemicals that are released
into your bloodstream and help to change how big or how small
your blood vessels are.
So we think if your cells are low on oxygen, then your body
might be releasing more of these nitrate chemicals in
order to deliver more oxygen.
It's a bit like if you've got a traffic jam on a road and
you get the builders in to build more lanes so more
people can travel at the same time.
So nitrates are a bit like the builders, perhaps.
We believe that we're right on the cusp of making a
fundamental discovery that will have a major impact on
our patients back at home.
The science of it is just so interesting.
And to be able to come here and not just do science, but
see this is amazing.
The amount of data that we will be able to take home from
this, and analyse, and hopefully change the way that
people think about low levels of oxygen in critically ill
patients, if we can change that, then it will definitely
have been worth coming up here time and time again.