Article: High-Altitude Research in Bolivia

Real work begins in journey to treat altitude illness

After a 6,250 mile journey from Bolivia to Scotland, the samples from the APEX 4 expedition are being analyzed by the University of Edinburgh as part of the ongoing research on altitude sickness. At every critical control point in the samples’ journey, World Courier staff went into the cargo areas to access the six boxes, and everything was checked. More dry ice was added at every step to ensure that this one-of-a-kind shipment stayed deep frozen.

With the expedition complete and the analysis ongoing, it’s time to look back at the most important aspect of the expedition: the research itself. The volunteers were subject to testing before and throughout the trip, including ultrasound scans, questionnaires and blood tests, so that the effects of altitude could be monitored.

One of the things that the researchers are hoping to acquire further insight on is novel genetic differences in individuals who develop fluid in the lungs. This is one of the potentially fatal conditions at altitude and the research looks to predict with greater accuracy, prevent and treat those who may be affected. Currently, more than 50% of the 35 million people who ascend to altitude each year suffer from some form of altitude illness. This has implications not just for extreme climbers but those who ascend for work, tourists, travelers and pilgrims.

The condition is very similar to illnesses suffered by the sickest patients around the world in intensive care units with low blood oxygen levels. These conditions are often fatal, and altitude offers us the chance to study the pathways that cause these illnesses without the confounding illnesses suffered by these already-ill patients.

Following their trek up the mountain, a number of the volunteers have stayed in South America for the full cultural experience. We’ll be going to Edinburgh to meet up with them when they get back from the summer break, so if you have any questions for the team, drop us a line and we’ll be sure to raise your question or comment to the group (marketing@worldcourier.co.uk).

New Heights Reached

APEX research concludes; samples returning to Scotland

Posted: Sunday, June 15, 2014

The APEX expedition has been a rollercoaster ride, with all the ups, downs and projectile vomiting that you might expect.
While there have been technical difficulties in the lab, the team has gelled through the moments of collective breathlessness and nausea-taking APEX to new heights (pun definitely intended). The lab was a stunning place to spend a week, with the peak of Huayni Potosi and the Cordillera Real looming as a backdrop.

One volunteer described the mixture of sore heads and busy testing schedules that the team expected and experienced over the course of its stay on the mountain, along with a couple unexpected challenges.

“We had a minor panic when we had a sudden power-cut. After some negotiations with the nearby lab we were able to fix this in time for testing today. Wayne has now completed his scanning of the lungs and optic nerves, Guido is finishing off the last few echo scans of hearts and Ally and the coag team are making great progress with ROTEM, multiplate and plasma analyses.”

“Unfortunately, the full blood counter (FBC, a vital part of Ally’s coagulation study) decided not to cooperate and has not worked at all at altitude. After some impressive attempts by the coag team over the past few day to nurse the faltering giant back to life, it was eventually pronounced dead at 20:24 on Sunday the 8th June. We were fortunately able to make arrangements with a local lab to have the samples analyzed.”

Additional drama struck when medics were called to the rescue of 5-year-old Diego, a boy who had come up to Chacaltaya with his mountain guide mother. Diego had spent his whole life at 3650 meters in La Paz and had been up as far as 4000 meters before. But upon reaching the towering heights of 5,300 meters at Chacaltaya, he became very unwell with acute mountain sickness. After a quick examination and some reassurance from Matt the medic, Diego and his mum were soon safely on their way back down to La Paz. This shows how a change in altitude can seriously affect even those who have spent their lives at altitude.

The samples were all bagged up and packed into thermal boxes with dry ice by World Courier’s Gustavo Gomez from our Montevideo office. They have winged their way to Edinburgh via Lima, Miami and London—ready for the analysis to start this week.

What Goes Up Must Come Down

Preparations underway for sample transport

Posted: Wednesday, June 11, 2014

The APEX team of volunteers has now spent nearly a week at Chacaltaya Lab, in the mountains high above the already-high city of La Paz, Bolivia. Assuredly, it’s been an experience of a lifetime for some-perhaps a sickening one for others. With the team cut off from Internet access, i’s difficult to know for sure. Even the APEX Twitter feed has gone dark, a scenario that the group predicted might happen as it ascended on June 4. Questions will be answered as the team descends from its perch this week.

In the meantime, preparations are already underway to ensure the seamless and secure transport of blood samples from La Paz to APEX’s headquarters in Edinburgh, Scotland. Logistics experts at World Courier have planned the transport route, selected the appropriate packaging, scheduled dry ice supply and replenishment-all to ensure that these irreplaceable samples travel safely across the 6,250-mile journey. More pictures and insights from the final days of the expedition will come later this week.

Into Thin Air

Research begins as volunteers ascend the mountain

Posted: Friday, June 6, 2014

Up the mountain they’ve gone. Earlier this week, the APEX 4 team boarded vehicles and ascended the extra 1,200 meters from their initial base in La Paz, Bolivia to the Chacaltaya Laboratory-their home for eight days of research.

Prior to heading up the mountain, all volunteers completed ultrasound tests that will be compared to results at higher altitude. With assistance from the local medical school, arrangements have also been made for local storage of blood samples in a -80°C freezer. At the end of the study, these samples will be packaged up and brought back to Edinburgh, Scotland by World Courier.

The team has faced some minor challenges already: the 300 kilograms of equipment that was transported as part of their luggage was stalled in customs for a couple days. With World Courier’s assistance, the equipment made its way through customs today-and so the research should begin in earnest this weekend.

APEX 4 Team Departs for La Paz, Bolivia

What will the on-site research encompass at 17,000+ feet?

Posted: Monday, June 2, 2014

The APEX 4 expedition’s 30 volunteers from Edinburgh University have left Scotland, loaded up with 300 kilograms of equipment and en route to La Paz via Amsterdam and Lima.

The group’s mission: Investigate the effects of high altitude on healthy human subjects and increase understanding of the severe and often unappreciated risks of high-altitude. The research has the potential to affect millions worldwide, not just travelers but also patients needing critical care medicine. Before the team left, World Courier talked to the researchers to see what they have planned for the volunteers during their time at 17.000 feet.

There are minimally-invasive daily tests which will be done, even if they are feeling unwell, including:

• Blood samples to look for changes that may account for differences in fluid accumulation
  Non-invasive heart and lung ultrasound imaging to identify fluid accumulation
  Acute Mountain Sickness symptom questionnaires

The final tests, looking at the effects of exercise on fluid accumulation in the lungs, will only go ahead if the volunteers feel well enough. Early effects of mild altitude sickness can feel like a hangover, so it’s likely that the volunteers may not want to do anything particularly physical.
Part of their essential kit includes table tennis and board games to keep the team active both mentally and physically, so let’s hope they will feel up to it.

They have already taken the first of the blood samples in Edinburgh, which will be compared with the samples that World Courier will transport back from Bolivia at the end of the trip, as a part of our expedition sponsorship.

Reading about what is happening up on the mountain and follow the APEX 4 team’s progress by checking this blog regularly. We’ll also post updates on World Courier’s LinkedIn page, so make sure to follow us there as well. For more information on APEX, visit altitude.org or follow the organization on Twitter.

World Courier Announces Sponsorship of APEX 4

Research will advance understanding of high-altitude’s impact on the body

Posted: Tuesday, May 27, 2014

This month, 30 healthy volunteers will conduct eight days of research in the Bolivian mountains — living and working at 5,200 meters (17,000 feet) above sea level. Their goal: Advance the medical community’s understanding of the impact of altitude on the human body. With them through each stage of their research will be World Courier.

For the third time, World Courier is proud to sponsor the research of the Altitude Physiology Expeditions (APEX), a registered Scottish charity that performs quality medical research in high-altitude regions of the world. The World Courier name will adorn the jackets of all 30 volunteers, but that’s only the tip of the iceberg — or mountain, as it were. We will also transport the research samples from the Chacaltaya Laboratory in Bolivia to APEX’s headquarters in Scotland. It’s work that requires precision, quality and care, and we’re thrilled to be part of it.

The applicability of this research isn’t limited only to understanding and treating altitude illness — which is a life-threatening condition on its own. The research has implications for any travelers visiting high-altitude regions. Potentially, it could also benefit critical care medicine by advancing treatment for patients with low blood oxygen levels.

APEX’s research team will send us daily updates, so follow along with their progress by checking this blog regularly. We’ll also post updates on World Courier’s LinkedIn page, so make sure to follow us there as well.

For more information on APEX, visit altitude.org.