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Oxygen therapy for acute myocardial infarction: A systematic review and meta-analysis

Burls, A, Cabello, JB, Emparanza, JI, Bayliss, S and Quinn, T (2011) Oxygen therapy for acute myocardial infarction: A systematic review and meta-analysis Emergency Medicine Journal, 28 (11). 917 - 923. ISSN 1472-0205

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Fig 1_ Flow diagram of study selection.pdf
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Fig 3_Oxygen vs air - Death in hospital.pdf
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Fig 4_Oxygen vs air - opiate use.pdf
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table 1_Characteristics of included studies.pdf
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Abstract

Oxygen (O2) is widely recommended in international guidelines for treatment of acute myocardial infarction (AMI), but there is uncertainty about its safety and benefits. A systematic review and meta-analysis were performed to determine whether inhaled O2 in AMI improves pain or the risk of death. Cochrane CENTRAL Register of Controlled Trials, MEDLINE, MEDLINE In-Process, EMBASE, CINAHL, LILACS and PASCAL were searched from start date to February 2010. Other sources included British Library ZETOC, Web of Science, ISI Proceedings, relevant conferences, expert contacts. Randomised controlled trials of inhaled O2 versus air in patients with suspected or proven AMI of < 24 h onset were included. Two authors independently reviewed studies to confirm inclusion criteria met, and undertook data abstraction. Quality of studies and risk of bias was assessed according to Cochrane Collaboration guidance. Main outcomes were death, pain, and complications. Measure of effect used was the RR. Three trials (n=387 patients) were included. Pooled RR of death on O2 compared to air was 2.88 (95%CI 0.88 to 9.39) on ITT analysis and 3.03 (95%CI 0.93 to 9.83) in confirmed AMI. While suggestive of harm, this could be a chance occurrence. Pain was measured by analgesic use. Pooled RR for the use of analgesics was 0.97 (95%CI 0.78 to 1.20). Evidence for O2 in AMI is sparse, of poor quality and pre-dates advances in reperfusion and trial methods. Evidence is suggestive of harm but lacks power and excess deaths in the O2 group could be due to chance. More research is required.

Item Type: Article
Additional Information: This article has been accepted for publication in Emergency Medicine Journal 28(11):917-923, 2011 following peer review and can also be viewed on the journal’s website at http://emj.bmj.com/content/28/11/917
Divisions: Faculty of Health and Medical Sciences > Health and Social Care
Depositing User: Symplectic Elements
Date Deposited: 11 Sep 2012 12:35
Last Modified: 23 Sep 2013 18:46
URI: http://epubs.surrey.ac.uk/id/eprint/7273

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