Oxygen therapy in ST-elevation myocardial infarction

Hofmann, Robin; Witt, Nils; Lagerqvist, Bo; Jernberg, Tomas; Lindahl, Bertil; Erlinge, David; Herlitz, Johan; Alfredsson, Joakim; Linder, Rikard; Ömerovic, Elmir; Angerås, Oskar; Venetsanos, Dimitrios; Kellerth, Thomas; Sparv, David; Lauermann, Jörg; Barmano, Neshro; Verouhis, Dinos; Östlund, Ollie; Svensson, Leif; James, Stefan

doi:10.1093/eurheartj/ehy326

Cited by 38 publications

(33 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the subsequent DETO2X-AMI trial to evaluate the effects of supplemental oxygen on hard clinical endpoints, Hofmann and colleagues (8) found that the routine use of supplemental oxygen in patients with suspected MI who did not have hypoxemia did not reduce or increase the 1-year all-cause mortality. When focusing on patients with ST-elevation MI, they found a similar result (9). Two meta-analyses of oxygen therapy in patients with acute MI reached the same conclusions, which were that oxygen therapy was not associated with important clinical outcomes in normoxemic patients (10,11).…”

Section: Discussionmentioning

confidence: 67%

Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled pilot study

Yang¹,

Shang²,

Yuan³

2019

J. Thorac. Dis.

View full text Add to dashboard Cite

Background: Data on the safety and feasibility of pulse oxygen saturation (SpO 2 ) directed oxygen therapy in mainland China are scarce. The aim of this pilot study was to test the feasibility of SpO time to death within 28 days between the two groups was not different (P=0.284). Conclusions: SpO 2 directed oxygen therapy in critically ill patients was feasible. Our pilot trial necessitates and rationalizes our large-sample multicenter trial.

show abstract

Section: Discussionmentioning

confidence: 67%

Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled pilot study

Yang¹,

Shang²,

Yuan³

2019

J. Thorac. Dis.

View full text Add to dashboard Cite

show abstract

“…Studies that were based on comparable patient populations, treatment protocols, and outcome measures were included in the meta-analysis. Reports that were post hoc analyses of already included studies [23][24][25][26][27][28][29][30][31][32][33][34] and reports by authors scrutinized for scientific and ethical misconduct [35][36][37][38][39] were excluded from the meta-analysis. Of the 173 studies, 95 studies segregated in a total of 49 bodies of evidence were qualified for meta-analysis (Table S1 in Additional file 1).…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…[47,48] ‡ We excluded two studies that reported post hoc analyses of long-term mortality of the same patient population whose short-term mortalities had already been reported and included in our analysis. [23,24] § We used the data for short-term mortality when mortalities at different time points were reported for one study.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Efficacies of Normobaric Oxygen Therapy in Healthcare: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Huang¹,

Zhao²,

Brackett³

et al. 2019

Preprint

View full text Add to dashboard Cite

BackgroundNormobaric oxygen therapy is one of the most commonly used treatments in healthcare; however, oxygen is not a panacea. There is currently a lack of a comprehensive review summarizing different normobaric oxygen therapies and their therapeutic efficacies based on randomized controlled trials across healthcare. MethodsWe systematically searched Ovid MEDLINE, Ovid Embase, Web of Science, and the Cochrane database from inception to April 4, 2019, for randomized controlled trials investigating the therapeutic efficacy of normobaric oxygen therapy compared to usual care. Two investigators independently extracted study data and assessed study quality.ResultsA total of 173 studies involving 81,792 patients were included in qualitative analysis, and 95 of these studies, segregated in 49 bodies of evidence according to methods of oxygen therapy used, patient populations treated, and outcomes measured, were included in meta-analyses. Normobaric oxygen therapy was guided by oxygen flow, inspired oxygen fraction (FiO2), or an oxygenation monitor. Each method had multiple different protocols. Eighteen different outcome measures were commonly used to assess the therapeutic efficacy. Ten (20%), 2 (4%) and 37 (76%) bodies of evidence suggested a beneficial, harmful, and futile effect, respectively. The quality of only two bodies of evidence (4%) was high, i.e., the significant reduction of prematurity-related mortality and necrotizing enterocolitis by 91-95% pulse oxygen saturation-guided therapy. The quality of the remaining 47 bodies of evidence was moderate (39%), low (43%), or very low (14%). Contrary to the World Health Organization recommendation, 80% FiO2-guided oxygen therapy did not affect surgical site infection in intubated surgical patients (risk ratio, 0.84; 95% confidence interval, 0.69 to 1.01; p=0.07; moderate quality).ConclusionsNormobaric oxygen therapy is widely used across healthcare; however, more than 70% of bodies of evidence suggested a futile effect and the quality of more than 50% of bodies of evidence was low or very low. How to best use normobaric oxygen therapy deserves further research.

show abstract

“…The DETO2X-AMI trial conducted in Sweden had allcause mortality at 1 year as the primary outcome and included more than 6000 patients with suspected MI who were randomized to either O 2 therapy or air; the trial showed no difference between the groups [4]. A substudy of the trial focusing on STEMI patients (n = 2807) randomized to O 2 therapy or air, also showed no differences between the groups in regard to one-year all-cause mortality or morbidity [8]. They did not however evaluate whether there were any differences based on culprit vessel.…”

Section: Discussionmentioning

confidence: 99%

“…Because of contradicting results and small studies, the cardiovascular effects of supplemental O 2 therapy in canines, healthy individuals as well as individuals with MI was for a long time unclear [3]. Recent randomized controlled trials (RCT) on patients with suspected [4][5][6] as well as confirmed MI [7] and ST Elevation Myocardial Infarction (STEMI) [8][9][10][11][12][13][14] have however shown no positive nor negative cardiovascular effects of supplemental O 2 therapy. Consequently, both the current guideline of the European Society of Cardiology for the management of STEMI [15], as well as the recently published British Medical Journal rapid recommendation on oxygen therapy [16], recommend that supplemental O 2 therapy should not be administrated in patients with MI and a blood oxygen saturation of ≥90%.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Oxygen (O 2 ) treatment has been a cornerstone in the treatment of patients with myocardial infarction. Recent studies, however, state that supplemental O 2 therapy may have no effect or harmful effects in these patients. The aim of this study was thus to evaluate the effect of O 2 therapy in patients with ST Elevation Myocardial Infarction (STEMI) based on the culprit vessel; Left Anterior Descending Artery (LAD) or Non-LAD. Methods: This was a two-center, investigator-initiated, single-blind, parallel-group, randomized controlled trial at the Skåne university hospital, Sweden. A simple computer-generated randomization was used. Patients were either randomized to standard care with O 2 therapy (10 l/min) or air until the end of the primary percutaneous coronary intervention. The patients underwent a Cardiac Magnetic Resonance Imaging (CMRI) days 2-6. The main outcome measures were Myocardium at Risk (MaR), Infarct Size (IS) and Myocardial Salvage Index (MSI) as measured by CMRI, and median high-sensitive troponin T (hs-cTnT). Results: A total of 229 patients were assessed for eligibility, and 160 of them were randomized to the oxygen or air arm. Because of primarily technical problems with the CMRI, 95 patients were included in the final analyses; 46 in the oxygen arm and 49 in the air arm. There were no significant differences between patients with LAD and Non-LAD as culprit vessel with regard to their allocation (oxygen or air) with regards to MSI, MaR, IS and hs-cTnT. Conclusion:The results indicate that the location of the culprit vessel has probably no effect on the role of supplemental oxygen therapy in STEMI patients. Trial registration: Swedish Medical Products Agency (EudraCT No. 2011-001452-11) and ClinicalTrials.gov Identifier (NCT01423929).

show abstract

Oxygen therapy in ST-elevation myocardial infarction

Abstract: Routine use of supplemental oxygen in normoxemic patients with STEMI undergoing primary PCI did not significantly affect 1-year all-cause death, rehospitalization with MI, cardiogenic shock, or stent thrombosis.

Cited by 38 publications

References 28 publications

Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled pilot study

Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled pilot study

Therapeutic Efficacies of Normobaric Oxygen Therapy in Healthcare: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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

Contact Info

Product

Resources

About