Oxygen therapy for acute myocardial infarction

Cabello, Juan B; Burls, Amanda; Emparanza, José Ignacio; Bayliss, Susan; Quinn, Tom

doi:10.1002/14651858.cd007160.pub3

Cited by 34 publications

(25 citation statements)

References 51 publications

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“…16,17 McNulty et al 4 showed that breathing supplemental oxygen for 15 minutes with a mask increases coronary vascular resistance by 40% and decreases Doppler flow velocity by 20% and coronary blood flow by 30% in patients undergoing cardiac catheterization.…”

Section: Discussionmentioning

confidence: 99%

Hyperoxia Exacerbates Myocardial Ischemia in the Presence of Acute Coronary Artery Stenosis in Swine

Guensch

Fischer

Shie

et al. 2015

Circ: Cardiovascular Interventions

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Background-Current guidelines limit the use of high oxygen tension after return of spontaneous circulation after cardiac arrest, focusing on neurological outcome and mortality. Little is known about the impact of hyperoxia on the ischemic heart. Oxygen is frequently administered and is generally expected to be beneficial. This study seeks to assess the effects of hyperoxia on myocardia oxygenation in the presence of severe coronary artery stenosis in swine. Methods and Results-In 22 healthy pigs, we surgically attached a magnetic resonance compatible flow probe to the left anterior descending coronary artery (LAD). In 11 pigs, a hydraulic occluder was inflated distal to the flow probe. After increasing PaO 2 to >300 mm Hg, LAD flow decreased in all animals. In 8 stenosed animals with a mean fractional flow reserve of 0.64±0.02, hyperoxia resulted in a significant decrease of myocardial signal intensity in oxygenationsensitive cardiovascular magnetic resonance images of the midapical segments of the LAD territory. This was not seen in remote myocardium or in the other 8 healthy animals. The decreased signal intensity was accompanied by a decrease in circumferential strain in the same segments. Furthermore, ejection fraction, cardiac output, and oxygen extraction ratio declined in these animals. Changing PaCO 2 levels did not have a significant effect on any of the parameters; however, hypercapnia seemed to nonsignificantly attenuate the hyperoxia-induced changes. Conclusions-Ventilation-induced hyperoxia may decrease myocardial oxygenation and lead to ischemia in myocardium subject to severe coronary artery stenosis. (Circ Cardiovasc Interv. 2015;8:e002928.

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Section: Discussionmentioning

confidence: 99%

Hyperoxia Exacerbates Myocardial Ischemia in the Presence of Acute Coronary Artery Stenosis in Swine

Guensch

Fischer

Shie

et al. 2015

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

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“…Sublingual nitrates are also commonly used. There is no clear consensus, despite meta-analysis, on whether oxygen should be delivered in acute MI93 but it is likely to be of use in those who are breathless, hypoxic or who have heart failure. A 300 mg chewed loading dose of aspirin should be offered to the patient as long as there are no contraindications 94 95.…”

Section: Acs On Operationsmentioning

confidence: 99%

Coronary artery disease in the military patient

Parsons

White

Gill³

et al. 2015

J R Army Med Corps

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Ischaemic heart disease is the most common cause of sudden death in the UK, and the most common cardiac cause of medical discharge from the Armed Forces. This paper reviews current evidence pertaining to the diagnosis and management of coronary artery disease from a military perspective, encompassing stable angina and acute coronary syndromes. Emphasis is placed on the limitations inherent in the management of acute coronary syndromes in the deployed environment. Occupational issues affecting patients with coronary artery disease are reviewed. Consideration is also given to the potential for coronary artery disease screening in the military, and the management of modifiable cardiovascular disease risk factors, to help decrease the prevalence of coronary artery disease in the military population.

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“…6 More recent studies have called this routine practice into question, with a similar signal toward more negative outcomes. 7 Adverse physiological effects of supplemental oxygen related to increasing coronary vascular resistance and generation of reactive oxygen species have been described, 8,9 fueling the need for an adequately powered randomized, clinical trial. 7 In this issue of Circulation, Stub and colleagues 10 sought to determine the relationship between supplemental oxygen compared with no oxygen therapy with infarct size in normoxic patients with STEMI undergoing primary PCI within the Air Versus Oxygen Myocardial Infarction (AVOID) study.…”

Section: Article See P 2143mentioning

confidence: 99%

“…7 Adverse physiological effects of supplemental oxygen related to increasing coronary vascular resistance and generation of reactive oxygen species have been described, 8,9 fueling the need for an adequately powered randomized, clinical trial. 7 In this issue of Circulation, Stub and colleagues 10 sought to determine the relationship between supplemental oxygen compared with no oxygen therapy with infarct size in normoxic patients with STEMI undergoing primary PCI within the Air Versus Oxygen Myocardial Infarction (AVOID) study. Accordingly, 638 patients with suspected STEMI were enrolled in the field by paramedics serving 9 metropolitan hospitals in Melbourne, Australia, between October 2011 and July 2014, of whom 441 had confirmed STEMI.…”

Section: Article See P 2143mentioning

confidence: 99%