A randomised controlled trial of the effect of high concentration oxygen on myocardial ischaemia during exercise

Ranchord, Anil; Perrin, Kyle; Weatherall, Mark; Beasley, Richard; Simmonds, Mark

doi:10.1016/j.ijcard.2011.04.017

Cited by 6 publications

(3 citation statements)

References 42 publications

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“…A study of 16 healthy individuals using MRI found that coronary artery oxygen delivery fell by 11% due to decreased cardiac output and decreased left ventricular perfusion while breathing oxygen at 8 L/min via a mask despite the increased blood oxygen content 317. However, Ranchord et al 318 found that high-concentration oxygen increased the time to onset of exercise-induced myocardial ischaemia in patients with stable ischaemic heart disease, suggesting that the physiology of oxygen delivery to the heart may be different during exercise in ischaemic heart disease. Reduced myocardial oxygen consumption might also be associated with reduced contractility.…”

Section: Section 8: Emergency Oxygen Use In Hospital Settingsmentioning

confidence: 98%

BTS guideline for oxygen use in adults in healthcare and emergency settings

O’Driscoll

Howard

Earis

et al. 2017

Thorax

487

376

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Section: Section 8: Emergency Oxygen Use In Hospital Settingsmentioning

confidence: 98%

BTS guideline for oxygen use in adults in healthcare and emergency settings

O’Driscoll

Howard

Earis

et al. 2017

Thorax

487

376

View full text Add to dashboard Cite

“…Interestingly, this concept of a prolonged margin of safety seems to be valid in coronary artery disease for O 2 breathing as a preventive, pre-treatment measure: breathing 15 L/min O 2 prevented the recurrence of pacing- [ 32 ] and prolonged the time until occurrence of exercise-induced angina [ 33 ].…”

Section: (Patho)physiology Of Hyperoxia: Pulmonary Vascular Metabolmentioning

confidence: 99%

Hyperoxia in intensive care, emergency, and peri-operative medicine: Dr. Jekyll or Mr. Hyde? A 2015 update

Häfner

Beloncle

Koch

et al. 2015

Ann. Intensive Care

164

116

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This review summarizes the (patho)-physiological effects of ventilation with high FiO2 (0.8–1.0), with a special focus on the most recent clinical evidence on its use for the management of circulatory shock and during medical emergencies. Hyperoxia is a cornerstone of the acute management of circulatory shock, a concept which is based on compelling experimental evidence that compensating the imbalance between O2 supply and requirements (i.e., the oxygen dept) is crucial for survival, at least after trauma. On the other hand, “oxygen toxicity” due to the increased formation of reactive oxygen species limits its use, because it may cause serious deleterious side effects, especially in conditions of ischemia/reperfusion. While these effects are particularly pronounced during long-term administration, i.e., beyond 12–24 h, several retrospective studies suggest that even hyperoxemia of shorter duration is also associated with increased mortality and morbidity. In fact, albeit the clinical evidence from prospective studies is surprisingly scarce, a recent meta-analysis suggests that hyperoxia is associated with increased mortality at least in patients after cardiac arrest, stroke, and traumatic brain injury. Most of these data, however, originate from heterogenous, observational studies with inconsistent results, and therefore, there is a need for the results from the large scale, randomized, controlled clinical trials on the use of hyperoxia, which can be anticipated within the next 2–3 years. Consequently, until then, “conservative” O2 therapy, i.e., targeting an arterial hemoglobin O2 saturation of 88–95 % as suggested by the guidelines of the ARDS Network and the Surviving Sepsis Campaign, represents the treatment of choice to avoid exposure to both hypoxemia and excess hyperoxemia.

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“…At the end of the trial, the KCTF will securely archive all central and site essential trial-related documentation and samples taken for a minimum of 10 years, in line with Medical Research Council (MRC) guidance on Good Research Practice 73 , and thereafter confidentially destroyed. All archived documents must be available for inspection and monitoring by appropriate authorities upon request.…”

Section: Trial Closurementioning

confidence: 99%

Children’s Oxygen Administration Strategies Trial (COAST): A randomised controlled trial of high flow versus oxygen versus control in African children with severe pneumonia

Maitland¹,

Kiguli²,

Opoka³

et al. 2018

Wellcome Open Res

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Background: In Africa, the clinical syndrome of pneumonia remains the leading cause of morbidity and mortality in children in the post-neonatal period. This represents a significant burden on in-patient services. The targeted use of oxygen and simple, non-invasive methods of respiratory support may be a highly cost-effective means of improving outcome, but the optimal oxygen saturation threshold that results in benefit and the best strategy for delivery are yet to be tested in adequately powered randomised controlled trials. There is, however, an accumulating literature about the harms of oxygen therapy across a range of acute and emergency situations that have stimulated a number of trials investigating permissive hypoxia. Methods: In 4200 African children, aged 2 months to 12 years, presenting to 5 hospitals in East Africa with respiratory distress and hypoxia (oxygen saturation < 92%), the COAST trial will simultaneously evaluate two related interventions (targeted use of oxygen with respect to the optimal oxygen saturation threshold for treatment and mode of delivery) to reduce shorter-term mortality at 48-hours (primary endpoint), and longer-term morbidity and mortality to 28 days in a fractional factorial design, that compares: Liberal oxygenation (recommended care) compared with a strategy that permits hypoxia to SpO 2 > or = 80% (permissive hypoxia); andHigh flow using AIrVO 2 TM compared with low flow delivery (routine care). Discussion: The overarching objective is to address the key research gaps in the therapeutic use of oxygen in resource-limited setting in order to provide a better evidence base for future management guidelines. The trial has been designed to address the poor outcomes of children in sub-Saharan Africa, which are associated with high rates of in-hospital mortality, 9-10% (for those with oxygen saturations of 80-92%) and 26-30% case fatality for those with oxygen saturations <80%. Clinical trial registration: ISRCTN15622505 Trial status: Recruiting

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A randomised controlled trial of the effect of high concentration oxygen on myocardial ischaemia during exercise

Cited by 6 publications

References 42 publications

BTS guideline for oxygen use in adults in healthcare and emergency settings

BTS guideline for oxygen use in adults in healthcare and emergency settings

Hyperoxia in intensive care, emergency, and peri-operative medicine: Dr. Jekyll or Mr. Hyde? A 2015 update

Children’s Oxygen Administration Strategies Trial (COAST): A randomised controlled trial of high flow versus oxygen versus control in African children with severe pneumonia

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