One Hundred Per Cent Oxygen in the Treatment of Acute Myocardial Infarction and Severe Angina Pectoris

Russek, Henry I.; Regan, Frederic D.; Naegele, Charles F.

doi:10.1001/jama.1950.02920050013003

Cited by 46 publications

(28 citation statements)

References 5 publications

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“…Three studies reported benefit with oxygen therapy in pacing-induced angina43 and exercise-induced angina,44 45 although similar benefits could not be demonstrated in later studies 46 47. The other study was that of Madias et al ,48 who suggested that the administration of oxygen therapy to patients experiencing a MI may reduce ischaemic injury, based on precordial ST-segment mapping.…”

Section: Discussionmentioning

confidence: 99%

Routine use of oxygen in the treatment of myocardial infarction: systematic review

Wijesinghe

Perrin

Ranchord

et al. 2008

Heart

149

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Context: International guidelines recommend the routine use of oxygen therapy in the treatment of myocardial infarction (MI). Objective: To undertake a systematic review and metaanalysis 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.Oxygen has been used in the treatment of myocardial infarction (MI) and acute coronary syndromes for over 100 years.1 The rationale for its longstanding use is that it increases oxygen delivery to the ischaemic myocardium, thereby reducing the size of the MI and improving clinical outcomes. Evidence in support of this approach is primarily derived from animal models, in which the administration of 100% oxygen under normobaric or hyperbaric conditions during and/or after experimental coronary artery occlusion reduces the extent of myocardial necrosis in some, 2-6 but not all, studies. 7-10However, concern has been expressed that the findings from animal studies may have poor generalisability to the clinical situation in humans. 11Furthermore, there is evidence that the routine use of high-flow oxygen in uncomplicated MI may not improve clinical outcomes and may potentially cause harm.11 12 It is well established that arterial oxygen tension is a major determinant of coronary artery tone [13][14][15][16] and that hyperoxia may result in a marked reduction in coronary artery blood flow. [17][18][19][20][21][22][23][24] Other cardiovascular effects of high-flow oxygen therapy include a reduction in cardiac output and stroke volume and an increase in systemic vascular resistance and blood pressure in patients with a MI. [25][26][27][28][29][30][31] Despite this conflicting evidence, contemporaneous international guidelines 32 33 recommend the routine use of supplemental oxygen in the treatment of MI. As the treatment of MI is at the forefront of evidence-based medicine, we sought to review the clinical efficacy and safety of the use of oxygen in this clinical situation. A systematic review was undertaken to identify randomised placebo-controlled trials of oxygen therapy in the treatment of acute MI with the intention of estimating differences in clinical outcomes by meta-analysis. METHODS Search strategyTo i...

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Section: Discussionmentioning

confidence: 99%

Routine use of oxygen in the treatment of myocardial infarction: systematic review

Wijesinghe

Perrin

Ranchord

et al. 2008

Heart

149

View full text Add to dashboard Cite

show abstract

“…Indeed recent debate in the cardiology literature has challenged the long established practice of administering 100% oxygen to acute angina and myocardial infarction (MI). Yet the first caution that administering 100% oxygen may be detrimental to ischemic myocardium in the normoxic patient was issued as long ago as 1950 [32]. In 1969 Bourassa et al [33] reported from experimental studies that high flow oxygen can reduce coronary blood flow sufficiently to worsen outcomes.…”

Section: The Danger Of Oxygen During Emergency Therapymentioning

confidence: 99%

To Give or Not To Give - Is that the Question?: The Changing Face of Emergency Oxygen Therapy

Kelly¹,

Lynes

2015

Int J Crit Care Emerg Med

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“…In 1939 Riseman et al demonstrated that oxygen increased the workload that could be achieved before the development of angina in 11 of 17 patients[4]. However in1950 Russek et al reported that in 4 of 5 patients, oxygen resulted in either more pronounced or longer ECG manifestations of myocardial ischaemia during exercise compared to room air[20]. In 1961 Pons et al reported a reduction in ST segment depression during exercise with oxygen treatment in 8 of 10 patients[2].…”

mentioning

confidence: 99%

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

Ranchord

Perrin

Weatherall

et al. 2012

International Journal of Cardiology

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One Hundred Per Cent Oxygen in the Treatment of Acute Myocardial Infarction and Severe Angina Pectoris

Abstract: oxygen therapy in circulatory failure. When this disorder arises as a result of acute myocardial infarction, the administration of oxygen may relieve dyspnea, cyanosis and cardiac pain and tide the patient over the initial crucial stages of the attack. The diminution in

Cited by 46 publications

References 5 publications

Routine use of oxygen in the treatment of myocardial infarction: systematic review

Routine use of oxygen in the treatment of myocardial infarction: systematic review

To Give or Not To Give - Is that the Question?: The Changing Face of Emergency Oxygen Therapy

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

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