In the debate about the planned use of the noble gas xenon with the aim of shortening the duration of Everest expeditions to one week, the international alpinism association UIAA has now also intervened. “According to current [scientific] literature, there is no evidence that breathing in xenon improves performance in the mountains, and inappropriate use can be dangerous,” reads a statement from the UIAA Medical Commission.
Furtenbach criticizes commission head
Lukas Furtenbach, head of the company Furtenbach Adventures, which wants to use xenon, describes the statement to me as “unscientific, full of methodological and substantive errors and misinterpretations and malicious insinuations”. According to Furtenbach, it contains the “false assertion that xenon has no effect on erythropoiesis [formation of red blood cells] and performance, according to which it would have to be removed from the WADA [doping] list immediately or should never have been included there in the first place.”
The statement reflects “only the personal opinion of Urs Hefti”, who has a close business relationship with a competitor and who has even confirmed to him in writing that the statement is his own opinion, says Furtenbach. The Swiss orthopaedic surgeon Hefti is the president of the 19-member UIAA commission.
Recommended dose?
According to the commission’s statement, xenon is an anesthetic gas and therefore a drug with corresponding side effects and health risks: “In an unmonitored setting this could be impaired brain function, respiratory compromise, and even death. One study showed significant sedation in people using it at doses recommended for mountaineering, Even slight sedation is detrimental in the potentially dangerous setting of high-altitude mountaineering.”
Furtenbach is puzzled by such a “recommended dose for mountaineering” as, according to Hefti, there have been no studies on the use of the gas in high-altitude mountaineering, says Lukas. “Who is supposed to have made this recommendation?” asks the Austrian, adding that “we are probably the only ones who have a data basis and experience from several years of research into the use of xenon for acclimatization.”
Furthermore, neither he nor his medical advisor, anaesthetist Dr. Michael Fries, had disclosed the exact mixing ratio of xenon and oxygen to be used. According to Furtenbach, the treatment also takes place so long before the exposure to altitude that no xenon could be detected in the body at the time of exposure to altitude, let alone any dangerous impairment of bodily functions by xenon. “Obviously, the UIAA medical commission did not even understand the basic application,” says Furtenbach, adding that Hefti and no one else from the commission contacted him or Fries at any time to find out more.
UIAA: “Xenon should be reserved for the operating room”
The UIAA statement goes on to say that acclimatization is an extremely complex process: “Since the physiological changes take days to weeks to influence the organism, from a physiological point of view, a single, one-off drug cannot be the key to improved acclimatization or increased performance. For erythropoietin in particular, the target of xenon, the effects take weeks to increase red blood cells, so use just before climbing would not be expected to make any difference in hemoglobin, hematocrit or performance.”
The conclusion of the UIAA physicians: “Xenon is rarely used in medicine and is not approved in all countries. Its use should be reserved for the operating room and procedural sedation by specialists with appropriate training in anesthesia. From a medical point of view, off-label use without a scientific basis and with unknown health risks must be rejected.”
Furtenbach: “Questionable alpine ethic”
In his own words, Furtenbach can only wonder about the UIAA’s statement: “In terms of argumentation theory, I find it exciting when an orthopaedic surgeon describes xenon, an anaesthetic gas with medical approval that has been used and researched in various areas of medicine for a good 75 years and whose safety and good tolerability is undisputed, as both ineffective and at the same time so dangerous that it must be warned against within one statement.”
He also asked himself another question, says Furtenbach: on the one hand, the commission is now warning against the medically supervised use of xenon as part of a comprehensive week-long acclimatization strategy including hypoxia training and the use of bottled oxygen when climbing at high altitudes. On the other hand, however, he cannot find a warning from the commission in any publication against high-altitude mountaineering on eight-thousanders without the use of bottled oxygen, regardless of how acclimatization is carried out, says Furtenbach: “I don’t want to give an estimate of how many people have already died on high mountains because they didn’t use bottled oxygen or how many people would not have died if they had been adequately warned of this danger instead of propagating a questionable ‘alpine ethic’.”
Note: The article was updated on 25 January to include Lukas Furtenbach’s statement.
