Oxygen Therapy in Patients with Acute Myocardial Infarction: A Systemic Review and Meta-Analysis

Abu‐Zaid, Ahmed; Fabrizio, Carly; Felpel, Kevin; Ashry, Haitham S. Al; Ranjan, Pragya; Elbadawi, Ayman; Mohamed, Ahmed H.; Barssoum, Kirolos; Elgendy, Islam Y.

doi:10.1016/j.amjmed.2017.12.027

Cited by 24 publications

(11 citation statements)

References 33 publications

(54 reference statements)

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“…This may reflect more recent evidence that the routine provision of supplemental oxygen does not appear to improve outcomes following acute MI. 26,27 The mean self-reported intraoperative FiO 2 administered by specialist anaesthetists in the present survey is lower than the practice patterns suggested from international observational data. A recent observational study of British anaesthetists found that the mean intraoperative FiO 2 administered to adult patients having non-cardiac surgery where an arterial cannula was placed by the treating anaesthetist, was 0.49.…”

Section: Comparison With Previous Studiescontrasting

confidence: 65%

Practice patterns and perceptions of Australian and New Zealand anaesthetists towards perioperative oxygen therapy

Frei

Beasley

Campbell

et al. 2019

Anaesth Intensive Care

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We conducted a survey of Australian and New Zealand anaesthetists to determine self-reported practice of perioperative oxygen administration and to quantify perceptions regarding the perceived benefits and risks resulting from liberal oxygen therapy delivered in a manner consistent with the current World Health Organization guidelines. In addition, we sought feedback on the acceptability of several proposed clinical trial designs aiming to assess the overall effect of liberal and restricted perioperative oxygen regimens on patient outcomes. We developed a 23-question electronic survey that was emailed to 972 randomly selected Australian and New Zealand College of Anaesthetists (ANZCA) Fellows. We received responses from 282 of 972 invitees (response rate 29%). The majority of survey participants indicated that they routinely titrate inspired oxygen to a level they feel is safe (164/282, 58%) or minimise oxygen administration (82/282, 29%), while 5% of respondents indicated that they aim to maximise oxygen administration. The mean value for targeted intraoperative fraction inspired oxygen (FiO2) was 0.41 (standard deviation 0.12). Of the survey respondents, 2/282 (0.7%) indicated they believe that routine intra- and postoperative administration of ≥80% oxygen reduces the risk of surgical site infection. Well-designed and conducted randomised trials on this topic may help to better direct clinicians' choices. A high level of willingness to participate (80% of responses) in a study designed to investigate the impact of differing approaches to perioperative oxygen administration suggests that recruitment is likely to be feasible in a future study.

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Section: Comparison With Previous Studiescontrasting

confidence: 65%

Practice patterns and perceptions of Australian and New Zealand anaesthetists towards perioperative oxygen therapy

Frei

Beasley

Campbell

et al. 2019

Anaesth Intensive Care

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“…The characteristics of AMI include rapid morbidity and high mortality. The key to improving the prognosis of AMI is the restoration of myocardial blood oxygen supply as soon as possible (10). At present, PCI is generally used to alleviate the clinical symptoms of AMI, by dredging the blocked coronary artery to promote the normal blood oxygen supply of the myocardium (11).…”

Section: Discussionmentioning

confidence: 99%

Effect analysis of kinetic energy progressive exercise in patients with acute myocardial infarction after percutaneous coronary intervention: a randomized trial

Jiang¹,

Mei²,

Zhang³

et al. 2021

Ann Palliat Med

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Background: Acute myocardial infarction (AMI) is the most common critical illness clinically.Percutaneous coronary intervention (PCI) can help patients with AMI by reopening their blocked blood vessels and improving clinical symptoms. Clinical practice has confirmed that rehabilitation training after PCI could significantly promote the recovery of patients' heart function, reduce cardiovascular events, and have a positive significance for prognosis. This study aimed to explore the effect of kinetic energy progressive exercise (PEKE) applied to patients with AMI after PCI.Methods: From April 2019 to April 2020, a total of 98 patients with AMI after PCI in our hospital were randomly allocated to PEKE group and routine intervention (RI) group. The RI group adopted routine intervention, while the PEKE group introduced PEKE intervention on the basis of the RI group. The incidence of adverse events (AEs), motor function, cardiac function, and quality of life (QoL) before and after intervention were compared between the two groups.Results: Compared with the RI group, the incidence of AEs in the PEKE group was significantly reduced (χ 2 =4.404, P=0.036). After 6 months of intervention, the maximum exercise load and metabolic equivalent of the PEKE group were greater than those of the RI group (t=7.114, 4.565; P=0.000, 0.000). After 6 months of intervention, the left ventricular ejection fraction (LVEF) of the PEKE group was greater than that of the RI group (t=6.826, P=0.000), and there were no significant differences in left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) compared with the RI group (t=1.253, 1.147; P=0.213, 0.254). After 6 months of intervention, the PEKE group's symptoms, physical function, cognitive function, psychosocial function, and satisfaction scores were greater than those in the RI group (t=5.991,

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“…Our findings were consistent with the results of studies that evaluated the impacts of supplemental oxygen therapy in other clinical settings. Several RCTs and meta-analyses have demonstrated that oxygen therapy does not significantly reduce all-cause mortality, and can even increase the incidence of early myocardial injury and infarct size among AMI patients with normoxemia [8,[10][11][12][13][29][30][31][32][33]. A total of 11 RCTs including 6366 patients with acute stroke showed a nonsignificant increase in mortality at 3, 6, and 12 months in patients who received normobaric oxygen compared with those who received ambient air [34].…”

Section: Discussionmentioning

confidence: 99%

Is oxygen therapy beneficial for normoxemic patients with acute heart failure? A propensity score matched study

Yao

Zhang

et al. 2021

Military Med Res

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Background The clinical efficiency of routine oxygen therapy is uncertain in patients with acute heart failure (AHF) who do not have hypoxemia. The aim of this study was to investigate the association between oxygen therapy and clinical outcomes in normoxemic patients hospitalized with AHF using real-world data. Methods Normoxemic patients diagnosed with AHF on ICU admission from the electronic ICU (eICU) Collaborative Research Database were included in the current study, in which the study population was divided into the oxygen therapy group and the ambient-air group. Propensity score matching (PSM) was applied to create a balanced covariate distribution between patients receiving supplemental oxygen and those exposed to ambient air. Linear regression and logistic regression models were performed to assess the associations between oxygen therapy and length of stay (LOS), and all-cause in-hospital as well as ICU mortality rates, respectively. A series of sensitivity and subgroup analyses were conducted to further validate the robustness of our findings. Results A total of 2922 normoxemic patients with AHF were finally included in the analysis. Overall, 42.1% (1230/2922) patients were exposed to oxygen therapy, and 57.9% (1692/2922) patients did not receive oxygen therapy (defined as the ambient-air group). After PSM analysis, 1122 pairs of patients were matched: each patient receiving oxygen therapy was matched with a patient without receiving supplemental oxygen. The multivariable logistic model showed that there was no significant interaction between the ambient air and oxygen group for all-cause in-hospital mortality [odds ratio (OR) 1.30; 95% confidence interval (CI) 0.92–1.82; P = 0.138] or ICU mortality (OR 1.39; 95% CI 0.83–2.32; P = 0.206) in the post-PSM cohorts. In addition, linear regression analysis revealed that oxygen therapy was associated with prolonged ICU LOS (OR 1.11; 95% CI 1.06–1.15; P < 0.001) and hospital LOS (OR 1.06; 95% CI 1.01–1.10; P = 0.009) after PSM. Furthermore, the absence of an effect of supplemental oxygen on mortality was consistent in all subgroups. Conclusion Routine use of supplemental oxygen in AHF patients without hypoxemia was not found to reduce all-cause in-hospital mortality or ICU mortality.

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Oxygen Therapy in Patients with Acute Myocardial Infarction: A Systemic Review and Meta-Analysis

Abstract: This meta-analysis confirms the lack of benefit of routine oxygen therapy in patients with acute myocardial infarction with normal oxygen saturation levels.

Cited by 24 publications

References 33 publications

Practice patterns and perceptions of Australian and New Zealand anaesthetists towards perioperative oxygen therapy

Practice patterns and perceptions of Australian and New Zealand anaesthetists towards perioperative oxygen therapy

Effect analysis of kinetic energy progressive exercise in patients with acute myocardial infarction after percutaneous coronary intervention: a randomized trial

Is oxygen therapy beneficial for normoxemic patients with acute heart failure? A propensity score matched study

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