Audible Bleeding

Rouleaux Club - Chris Imray, MBBS, PhD - Academia at Altitude


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Professor Chris Imray is a consultant vascular, renal transplant and trauma surgery at the University Hospitals Coventry & Warwickshire NHS Trust in Coventry, UK. He is also an Honorary Professor at Warwick Medical School, Coventry and Exeter Universities and immediate Past President of the Vascular Society of Great Britain and Ireland.

Professor Imray has combined his love of mountaineering with clinical vascular surgery - he is involved in a number of polar medicine societies and is a world expert on the management of frostbite and non-freezing cold injuries. He has conducted research into hypoxia and ischemia at altitude and has published extensively.

His personal accomplishments include a wide range of expeditions across the globe, from the sea cliffs of the Outer Hebrides in Scotland to the volcanoes of Chile and, most notably, to the summit of Everest.

Useful links:

Selected papers about altitude / extreme medicine:

  • Femoral stabs at 8400m with the lowest recorded ABGs: Grocott et al. Arterial blood gases and oxygen content in climbers on Mount Everest. N Engl J Med. 2009 Jan 8;360(2):140-9.
  • Transcranial Doppler at 8000m, with novel insights: Wilson et al Cerebral artery dilatation maintains
    cerebral oxygenation at extreme altitude and in acute hypoxia--an ultrasound and MRI study. J Cereb Blood Flow Metab. 2011 Oct;31(10):2019-29.
  • Novel insights from Everest (8000m) confirmed:
    • Sagoo et al. The use of MR to investigate the potential mechanisms involved in the development of high altitude cerebral oedema. J Cereb Blood Flow Metab. 2016 Jan 8. pii
    • Wilson et al.  The cerebral venous system and anatomical predisposition to high altitude headache. Annals of Neurology 2013
    • Wilson and Imray. The Cerebral Venous System and
      Hypoxia. J Appl Physiol. 2015 Aug 20:jap.00327.2015.
  • The effect of altitude on the brain: Wilson et al.  The cerebral effects of ascent to high altitudes. Lancet Neurol. 2009 Feb;8(2):175-91.
  • Women are at least as strong as men on hyper-endurance events: Hattersley et al.  A comparison of the metabolic effects of sustained strenuous activity in polar environments on men and women. Sci Rep. 2020 Aug 17;10(1):13912.
  • Evidence-based guidelines on the management of frostbite:
    • McIntosh et al. Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Frostbite: 2019 Update. Wilderness Environ Med. 2019 Jul 17. pii: S1080-6032(19)30097-3.
    • Handford et al. Frostbite: a practical approach to hospital management. Extrem Physiol Med. 2014 Apr 22;3:7.
  • Collaborative teamwork gives the best results: Fisher et al. Pedicled Abdominal Flaps for Enhanced Digital Salvage After Severe Frostbite Injury. Wilderness Environ Med. 2019 Mar;30(1):59-62.

Other useful resources

  • Information on the management of frostbite: 
    https://www.thebmc.co.uk/how-to-get-expert-frostbite-advice
  • Oxford Handbook of Wilderness and Expedition Medicine: https://oxfordmedicine.com/view/10.1093/med/9780199688418.001.0001/med-9780199688418
  • Media appearances by Prof Imray:
    • Radio: http://news.bbc.co.uk/today/hi/today/newsid_9722000/9722707.stm
    • Television: BBC Panorama: Horizon Doctors in the death zone: http://www.bbc.co.uk/sn/tvradio/programmes/horizon/broadband/tx/everest/
  • Polar medicine / extreme environment and research organisations:
    • https://worldextrememedicine.com/products/courses/polar-medicine/polar-medicine-norway/
    • https://www.rgs.org/in-the-field/advice-training/expedition-medicine-(1)/committee-members/
    • https://www.rgs.org/in-the-field/advice-training/resources-for-expeditions/global-polar-altitudemetabolic-research-registr/
    • https://bmrescouk.wordpress.com
    • https://www.xtreme-everest.co.uk/Scientific-Strategy-Group

The Vascular and Endovascular Research Network (VERN) COVER Study (COVID-19 Vascular sERvice Study): https://vascular-research.net/projects/cover-study-covid-19-vascular-service-study/

To learn more about The Rouleaux Club, visit http://rouleauxclub.com

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