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Routine use of oxygen in the treatment of myocardial infarction: systematic review
M Wijesinghe1, K Perrin, A Ranchord
1Medical Research Institute of New Zealand, Wellington, New Zealand.
Context:
International guidelines recommend the routine use of oxygen therapy in the treatment of myocardial infarction (MI).
Objective:
To undertake a systematic review and meta-analysis of randomised placebo-controlled trials of oxygen therapy in MI.
Data Sources:
Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, EMBASE and CINHAL.
Study Selection:
Randomised placebo-controlled trials of oxygen therapy in MI.
Data Extraction:
The primary clinical outcome was mortality.
Results:
Two of 51 potential studies met the inclusion criteria. The one study with substantive clinical outcome data reported that in uncomplicated MI, high-flow oxygen was associated with a non-significant increased risk of death (risk ratio 2.9, 95% CI 0.8 to 10.3, p = 0.08) and a greater serum aspartate aminotransferase level (difference 19.2 IU/ml, 95% CI 0 to 38.4, p = 0.05) than room air.
Conclusion:
The limited evidence that does exist suggests that the routine use of high-flow oxygen in uncomplicated MI may result in a greater infarct size and possibly increase the risk of mortality.
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