Effects of supplemental oxygen therapy in patients with suspected acute myocardial infarction: a meta-analysis of randomised clinical trials

  title={Effects of supplemental oxygen therapy in patients with suspected acute myocardial infarction: a meta-analysis of randomised clinical trials},
  author={Nariman Sepehrvand and Stefan K James and Dion Stub and Ardavan Khoshnood and Justin A. Ezekowitz and Robin Hofmann},
  pages={1691 - 1698}
Background Although oxygen therapy has been used for over a century in the management of patients with suspected acute myocardial infarction (AMI), recent studies have raised concerns around the efficacy and safety of supplemental oxygen in normoxaemic patients. Objective To synthesise the evidence from randomised controlled trials (RCTs) that investigated the effects of supplemental oxygen therapy compared with room air in patients with suspected or confirmed AMI. Methods For this aggregate… 

Oxygen therapy versus conservative therapy in suspected uncomplicated myocardial infarction without hypoxemia: A meta-analysis of randomized controlled studies

Compared with conservative therapy, oxygen therapy did not decrease the mortality at the longest duration of follow-up, discharge, 30 days, and 6 months in patients with suspected uncomplicated myocardial infarction and without hypoxemia at baseline.

Effect of oxygen supply on mortality in acute ST-elevation myocardial infarction: systematic review and meta-analysis.

High oxygen supply may be associated with a decrease in short-term mortality in STEMI patients, but the pooled data are not robust enough to allow definitive conclusions.

Routine Oxygen Therapy Does Not Improve Health-Related Quality of Life in Patients With Acute Myocardial Infarction—Insights From the Randomized DETO2X-AMI Trial

Routine oxygen therapy provided to normoxemic patients with acute MI did not improve HRQoL up to 1 year after MI occurrence, and no significant difference was observed between the treatment groups in EQ-5D dimensions.

Oxygen therapy in acute myocardial infarctions: do we need to re-evaluate its necessity?

Despite its clinical use over an extended period, adequately designed clinical trials did not appear until 2015 and the main mechanisms to explain the potential deleterious effects of excessive O2 therapy are the endothelial production of reactive oxygen species (ROS) and hyperoxia-induced vasoconstriction in the coronary, cerebral, and systemic vasculature.

High flow oxygen and risk of mortality in patients with a suspected acute coronary syndrome: pragmatic, cluster randomised, crossover trial

In a large patient cohort presenting with suspected ACS, high flow oxygen was not associated with an increase or decrease in 30 day mortality.

Is oxygen therapy beneficial for normoxemic patients with acute heart failure? A propensity score matched study

Routine use of supplemental oxygen in AHF patients without hypoxemia was not found to reduce all-cause in-hospital mortality or ICU mortality, and the absence of an effect of supplementary oxygen on mortality was consistent in all subgroups.

Oxygen therapy in patients with ST elevation myocardial infarction based on the culprit vessel: results from the randomized controlled SOCCER trial

The results indicate that the location of the culprit vessel has probably no effect on the role of supplemental oxygen therapy in STEMI patients.

German S3 Guideline: Oxygen Therapy in the Acute Care of Adult Patients

A national S3 guideline is developed and published within the Program for National Disease Management Guidelines (AWMF) with participation of 10 medical associations and includes 34 evidence-based recommendations about indications, prescription, monitoring and discontinuation of oxygen therapy in acute care.

Taking the Air Out of Oxygen Supplementation in Individuals With Diabetes and Acute Coronary Syndromes

Oxygen supplementation has been a cornerstone in the initial treatment of individuals with acute coronary syndrome and widespread belief in oxygen was highlighted in a survey of emergency department, cardiology, and ambulance staff in which 98% of respondents reported using oxygen supplementation for suspected MI and 55% believed oxygen reduced the risk of death.

An Audit of Paramedic Administration of Oxygen Therapy to Patients with Suspected Acute Coronary Syndrome

Although the results demonstrated a degree of compliance, this could be improved through clinical education, a review of the local chest pain guidelines, an introduction of a drug protocol for oxygen therapy and future research investigating the reasons for non-compliance to the best practice guidelines.



Oxygen therapy for acute myocardial infarction.

The evidence from randomised controlled trials is reviewed to establish whether routine use of inhaled oxygen in acute myocardial infarction (AMI) improves patient-centred outcomes, in particular pain and death.

Effect of oxygen therapy on myocardial salvage in ST elevation myocardial infarction: the randomized SOCCER trial

  • A. KhoshnoodM. Carlsson U. Ekelund
  • Medicine
    European journal of emergency medicine : official journal of the European Society for Emergency Medicine
  • 2018
The results support the safety of withholding supplemental oxygen in normoxic STEMI patients undergoing acute PCI, and found no effect of high-flow oxygen compared with room air on the size of ischemia before PCI, myocardial salvage, or the resulting infarct size.

Oxygen Therapy in Suspected Acute Myocardial Infarction

Routine use of supplemental oxygen in patients with suspected myocardial infarction who did not have hypoxemia was not found to reduce 1‐year all‐cause mortality.

Oxygen therapy for acute myocardial infarction.

There is no evidence from randomised controlled trials to support the routine use of inhaled oxygen in people with AMI, and the evidence is inconsistent and low quality, and one cannot rule out a harmful effect.

Oxygen use in acute myocardial infarction: an online survey of health professionals' practice and beliefs

Widespread belief in the benefit of oxygen in AMI may make it difficult to persuade funders of the importance of this issue and health professionals to participate in enrolling patients into a trial in which oxygen would be withheld from half their patients.

Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction

Supplemental oxygen exposure in the first 12 h after STEMI was associated with a clinically significant increase in cTnI and CK release.