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

Abstract

International guidelines recommend the routine use of oxygen therapy in the treatment of myocardial infarction (MI). To undertake a systematic review and meta-analysis of randomised placebo-controlled trials of oxygen therapy in MI. Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, EMBASE and CINHAL. Randomised placebo-controlled trials of oxygen therapy in MI. The primary clinical outcome was mortality. 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. 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.