Routine use of oxygen in the treatment of myocardial infarction: systematic review
- 1Medical Research Institute of New Zealand, Wellington, New Zealand
- 2Capital and Coast District Health Board, Wellington, New Zealand
- 3University of Otago Wellington, Wellington, New Zealand
- 4University of Southampton, Southampton, UK
- Professor R Beasley, Medical Research Institute of New Zealand, PO Box 10055, Wellington 6143, New Zealand;
- Accepted 1 July 2008
- Published Online First 15 August 2008
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.
MWi is a Wellington Hospitals and Health Foundation Research Fellow and KP is a Health Research Council of New Zealand Training Fellow. MWi and KP undertook the systematic review, MWe undertook the statistical analyses and all authors reviewed the studies identified and contributed to writing the manuscript.
Competing interests: None.