Rediscovered Everest breathing device leads to breakthrough in care
of COPD patients
13 November 2008
A partnership between Smiths Medical and University College London
(UCL) has resulted in the development of a breakthrough clinical device
that could transform the lives of patients with chronic obstructive
pulmonary disease (COPD) across the world. COPD will be the third
leading cause of death worldwide by 2030, according to the World Health
Organization (WHO).
The new technology is based on a closed-circuit oxygen device
invented over 50 years ago by the British rocket scientist Tom
Bourdillon, who hoped that it would help him become to first person to
climb to the top of Mount Everest.
Three days before Edmund Hillary and Tenzing Norgay made the first
ascent of Mount Everest in 1953, Bourdillon nearly got there first with
the help of his ground-breaking invention. When he and his climbing
partner Charles Evans, a British brain surgeon, set out on the first
ever summit attempt they were breathing pure oxygen from the device. It
helped them climb higher than any man had ever been before and at speeds
that have rarely been matched since.
The two men were just 90 metres from the summit when Evans’ device
malfunctioned, dashing their hopes of becoming the most celebrated
mountaineers in the world. Three days later Hillary and Norgay claimed
that honour using open circuit oxygen devices.
Bourdillon believed that closed circuit oxygen was more efficient and
effective than open circuit because a closed circuit efficiently
recycles exhaled oxygen, which would be lost to the atmosphere in an
open circuit.
His research was forgotten for 50 years but now Smiths Medical and
UCL have developed Bourdillon’s idea into a breakthrough medical device
that could help patients with COPD, which is a disease of the lungs in
which the airways become narrowed leading to a limitation of the flow of
air to and from the lungs, causing shortness of breath.
“We are hoping that this new technology will transform the lives of
people living with COPD by allowing them to breathe more easily,
exercise and ultimately reduce their dependence on oxygen. It is
incredible to think that this breakthrough device is based on a British
invention designed to help the first mountaineers reach the top of the
world,” said Dr Jeremy Russell, head of research and development at
Smiths Medical International.
Bourdillon’s research was rediscovered by Jeremy Windsor and Roger
McMorrow, mountaineering scientists at the UCL Centre for Altitude,
Space and Extreme Environment Medicine (CASE), who had the idea to
redevelop it into a modern breathing circuit for climbers.
“Bourdillon recognised that the problem on Everest was low levels of
oxygen and if you solved the problem of delivering oxygen you would
effectively reduce the height of the mountain to sea level,” said Dr
McMorrow. “No-one knows exactly why his device failed but when I tested
my prototype on Cho Oyu in the Himalayas 2005 it also failed. In my case
the soda lime CO2 absorber malfunctioned and it is possible Bourdillon
had the same problem although another theory is that it was a frozen
valve. A recently invented CO2 absorber called ExtendAir solved the
problem on my circuit.”
Dr McMorrow, when a Smiths Medical Research Fellow at UCL, showed his
mountaineering prototype to Dr Russell at Smiths Medical, which has a
long-standing partnership with UCL that includes collaboration on
research in the field of respiratory medicine.
The two scientists quickly realised that the prototype for
mountaineers had the potential to evolve into a ground-breaking device
for COPD patients as well as for other patients weaning from oxygen in
hospital and those on home oxygen.
Last year the device was successfully tested on Mount Everest at the
Smiths Medical High Altitude Laboratory at Namche Bazaar, Nepal at
3,400m, (11,154 ft) as part of the Caudwell Xtreme Everest Study (CXE),
a medical research project conducted by CASE. Smiths Medical is now
optimizing and miniaturizing the prototype for patients.
Exercise is important for COPD patients but existing oxygen systems
mean it is often not possible. The size of current open circuit systems
mean that patients are often confined to their hospital beds or treated
at home with large cylinders that severely restrict their mobility.
Portable open circuit systems are not able to deliver high enough
volumes of oxygen for long enough to permit exercise.
In an open circuit system the faster a person breathes the more they
dilute the oxygen with ordinary air. This means that if a patient
dependent on oxygen starts to exercise their oxygen levels actually drop
as their breathing grows faster. Dr Russell added: “The new system is
portable and should deliver a very high concentration of oxygen for a
sustained period of time. It should help keep oxygen levels constant no
matter how fast or slow a patient is breathing.”
Previously, portable closed circuits have been used by Special Forces
frogmen (because there are no bubbles), mine rescue workers,
firefighters and in bioterrorism suits. George Band, who was the
youngest member of the 1953 Everest expedition, said: “I remember how
passionate Tom was about his closed circuit device and how disappointed
he and Charles were not to make it to the summit. I’m sure Tom would
have been really thrilled that his research on the closed-circuit oxygen
equipment did not go to waste and could help people suffering from
respiratory problems today.”
Professor Monty Mythen, Smiths Medical Professor of Anaesthesia at
UCL and Director of Research and Development at UCL Hospitals said:
“This project is a fantastic example of the success that comes from
scientists in industry working closely with clinicians and university
academics for patient benefit. Smiths Medical in collaboration with UCL
and NHS Partners makes a formidable team and I am delighted that the
Caudwell Xtreme Everest expedition is beginning to reap rewards for
patients.”
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