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No benefit to supplemental oxygen in patients with acute MI and normal oxygen saturation
Clinical Question
Does routine oxygen therapy benefit patients with acute myocardial infarction and normal peripheral oxygen saturation levels?
Bottom line
Giving oxygen therapy to patients with acute myocardial infarction (MI) who have normal oxygen levels does not improve mortality nor reduce the incidence of further cardiovascular events. 1a
Reference
Study design: Meta-analysis (randomized controlled trials)
Funding: Self-funded or unfunded
Setting: Inpatient (any location) with outpatient follow-up
Synopsis
Previous studies have shown that routine oxygen therapy for patients with suspected MI and normal oxygen levels has no effect on mortality (https://www.essentialevidenceplus.com/content/poem/191204). For this meta-analysis, investigators searched multiple databases, including MEDLINE, Web of Science, and the Cochrane Collaboration of Clinical Trials, as well as abstracts from major cardiovascular conferences, to find randomized controlled trials and observational studies that evaluated outcomes in adult patients with acute MI and normal oxygen levels who received routine oxygen therapy. Outcomes included all-cause mortality, recurrent ischemia or MI, heart failure, and arrhythmia. Data were extracted by 2 independent groups, the quality of the studies was assessed using the Cochrane tool, and overall quality of the evidence was evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation tool. Seven studies, all randomized controlled trials, were included in the final analysis: 3842 patients in the routine oxygen therapy group and 3860 patients in the no oxygen therapy group. Results from the meta-analysis showed that oxygen therapy did not decrease mortality, did not reduce the number of recurrent ischemic events, and did not change the incidence of heart failure or arrhythmia. The level of evidence was rated as high for all outcomes. (http://www.essentialevidenceplus.com/content/poem/131201)
Reviewer
Nita Shrikant Kulkarni, MD
Assistant Professor in Hospital Medicine
Northwestern University
Chicago, IL
Comments
Good poem
please let the nursing staff know !
KIND OF OBVIOUS
Too scary not to give O2
Did the investigators look at medical-legal issues arising from families of injured and deceased AMI patients who were denied supplemental O2, I wonder.
Misconceptions about the role of oxygen in normal o2saturation patient