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Systematic review
Routine supplementary oxygen for the normoxic patient with suspected acute myocardial infarction is no longer warranted
  1. Tom Quinn
  1. Emergency, Cardiovascular and Critical Care Research Group, Centre for Health and Social Care Research, Kingston University and St George’s University of London, London, UK
  1. Correspondence to Professor Tom Quinn, Centre for Health and Social Care Research, Kingston University and St George’s University of London, London SW170RE, UK; T.Quinn{at}sgul.kingston.ac.uk

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Commentary on: Fu S, Lv X, Fang Q, et al. Oxygen therapy for acute myocardial infarction: a systematic review and meta-analysis. 2017;74:8–14.

Implications for practice and research

  • In the absence of robust evidence that oxygen is beneficial or harmful, patients with suspected acute myocardial infarction (AMI) should have oxygen therapy titrated to oxygen saturation levels in accordance with guidelines.

  • A large randomised trial, Determination of the role of oxygen in suspected acute myocardial infarction (DETO2X-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.

Context

Oxygen therapy has been a mainstay of emergency management of patients with suspected AMI for decades. In recent years, systematic reviews have raised concerns that oxygen may be harmful to patients with AMI, but the quality of evidence has been low. Following a Cochrane review …

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