Matthew W. Barton: Increased Cardiac Events with Use of Supplemental Oxygen Therapy for Adult Patients Suffering From Uncomplicated STEMIs

Increased Cardiac Events with Use of Supplemental Oxygen Therapy for Adult Patients Suffering From Uncomplicated STEMIs

ABSTRACT

Background: Although providers have been using supplemental oxygen therapy in the treatment of myocardial infarction for over 100 years, there are currently no current guidelines established for the treatment of normoxic patients. Research has shown possible worsened outcomes for uncomplicated myocardial infarctions when oxygen is used; including worsened ischemic area and increased arrhythmias. The aim of this systematic review is to evaluate the research on whether or not supplemental oxygen therapy can cause increased cardiac events for patients presenting with an uncomplicated AMI.

Methods: An exhaustive search of the literature was performed using MEDLINE-Ovid, Web of Science, and ClinicalKey. Key words included myocardial infarction, oxygen, and oximetry.

Results: Out of the 16 relevant articles found, only two articles fit all inclusion and exclusion criteria. Both studies showed evidence of increase infarct size and cardiac arrhythmias with supplemental oxygen use in uncomplicated myocardial infarctions. The overall quality of evidence was found to be moderate. Further studies are needed to show the long-term morbidity and mortality.

Conclusion: The use of supplemental oxygen in an uncomplicated AMI has been shown to cause an increase in infarct size as well as increased cardiac arrhythmias and recurrent myocardial infarcts. Although there is evidence to support short term worsened cardiac events, there are currently no studies for long-term morbidity and mortality. Further research is required to determine the long-term effects of oxygen supplementation for normoxic patients with acute myocardial infarctions.

Keywords: Myocardial infarction, oxygen, oximetry

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REVIEWED STUDIES:

Rawles JM, Kenmure AC. Controlled trial of oxygen in uncomplicated myocardial infarction. Br Med J. 1976;1(6018):1121-1123. Accessed 19760802.

Stub D, Smith K, Bernard S, et al. Air versus oxygen in ST-segment-elevation myocardial infarction. Circulation. 2015;131(24):2143-2150. Accessed 20150616. doi: http://dx.doi.org/10.1161/CIRCULATIONAHA.114.014494.

AUTHOR:  Matthew Barton is currently completing his second year in the School of PA Studies at Pacific University, Oregon.  He will graduate with an MS degree in August, 2016.