Oxygen Therapy in Suspected Acute Myocardial Infarction

Abstract

Routine use of supplemental oxygen in patients with suspected myocardial infarction who did not have hypoxemia was not found to reduce 1-year all-cause mortality. (Funded by the Swedish Heart-Lung Foundation and others; DETO2X-AMI ClinicalTrials.gov number, NCT01787110 .).

Oxygen therapy for acutely ill medical patients: a clinical practice guideline

“…For example, in the largest of eight trials of patients with stroke only 240 patients (3.1% of 7677 participants) had an initial SpO 2 of 90-93.9% 16. For myocardial infarction, six trials enrolled 7898 patients: in the largest trial, 1062 patients (16.0%) had an initial SpO 2 ≤94% 17. For all outcomes, the panel rated down the quality of the evidence for indirectness (uncertain applicability) in patients with a SpO 2 of 90-92%.…”

Effects of supplemental oxygen therapy in patients with suspected acute myocardial infarction: a meta-analysis of randomised clinical trials

“…Since then, several clinical trials addressing the same question22–24 have been completed. The most prominent study is the DETermination of the role of OXygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial, enrolling 6629 patients into a registry-based randomised controlled trials (RCTs)22 25 in which supplemental O 2 therapy was not associated with reduced mortality or rehospitalisation within 1 year 22…”

Routine supplementary oxygen for the normoxic patient with suspected acute myocardial infarction is no longer warranted

“…A large randomised trial, Determination of the role of oxygen in suspected acute myocardial infarction (DETO 2 X-AMI),1 has recently reported no mortality difference at 365 days between normoxic patients with suspected AMI who received oxygen versus ambient suggesting supplementary oxygen can safely be withheld in such patients.…”

“…Randomisation and follow-up were performed using the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registry, linked to administrative datasets. The primary end point of death from any cause within 1 year after randomisation occurred in 5.0% of patients (166/3311) assigned to oxygen and in 5.1% of patients (168/3318) assigned to ambient air (HR 0.97; 95% CI 0.79 to 1.21, P=0.80) 1. This landmark trial has immediately influenced international guideline recommendations and will change practice worldwide 5.…”