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

@article{Sepehrvand2018EffectsOS,
  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},
  journal={Heart},
  year={2018},
  volume={104},
  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.

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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.

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

Long-Term Effects of Oxygen Therapy on Death or Hospitalization for Heart Failure in Patients With Suspected Acute Myocardial Infarction

Routine use of supplemental oxygen in normoxemic patients with suspected myocardial infarction was not found to reduce the composite of all-cause mortality and hospitalization for heart failure, or cardiovascular death within 1 year or during long-term follow-up.

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.

Oxygen therapy in acute resuscitation

Evidence is lacking to support routine liberal oxygen administration in acutely ill patients and, in most circumstances, a reasonable approach is to titrate supplemental oxygen to achieve an arterial oxygen saturation measured by pulse oximetry (SpO2) of 92–96% with the aim of avoiding both hypoxaemia and hyperoxaemic disease.

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Objective Supplemental oxygen therapy may increase myocardial injury following ST-elevation myocardial infarction (STEMI). In this study, we aimed to evaluate the effect of the dose and duration of
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