Oxygen therapy for suspected acute myocardial infarction – DETO2X-AMI
Authors:
O. Ludka
Authors‘ workplace:
Interní kardiologická klinika LF MU a FN Brno Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně
Published in:
Kardiol Rev Int Med 2018, 20(2): 137-141
Overview
Background:
The clinical effect of routine oxygen therapy in patients with suspected acute myocardial infarction without hypoxemia at baseline is uncertain.
Methods: In this registry-based randomized clinical trial, we used nationwide Swedish registries for patient enrolment and data collection. Patients with suspected myocardial infarction and an oxygen saturation of 90% or higher were randomly assigned to receive either supplemental oxygen (6 litre per minute for 6 to 12 hours, delivered through an open face mask) or ambient air.
Results:
A total of 6,629 patients were enrolled. The median duration of oxygen therapy was 11.6 hours, and the median oxygen saturation at the end of the treatment period was 99% among patients assigned to oxygen and 97% among patients assigned to ambient air. Hypoxemia developed in 62 patients (1.9%) in the oxygen group, as compared with 254 patients (7.7%) in the ambient-air group. The median of the highest troponin level during hospitalization was 946.5 ng per litre in the oxygen group and 983.0 ng per litre in the ambient-air group. The primary end point of death from any cause within 1 year after randomization occurred in 5.0% of patients (166 of 3,311) assigned to oxygen and in 5.1% of patients (168 of 3,318) assigned to ambient air (HR 0.97; 95% CI 0.79–1.21; P = 0.80). Re-hospitalization with myocardial infarction within 1 year occurred in 126 patients (3.8%) assigned to oxygen and in 111 patients (3.3%) assigned to ambient air (HR 1.13; 95% CI 0.88–1.46; P = 0.33). The results were consistent across all predefined subgroups.
Conclusions:
Routine use of supplemental oxygen in patients with suspected myocardial infarction without hypoxemia was not found to reduce 1-year all-cause mortality.
Key words
myocardial infarction – oxygen
Sources
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Paediatric cardiology Internal medicine Cardiac surgery CardiologyArticle was published in
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