Supplemental Oxygen and Acute Myocardial Infarction - A Systematic Review and Meta-Analysis.
Supplemental Oxygen and Acute Myocardial Infarction - A Systematic Review and Meta-Analysis.
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DOI：
10.1253/circrep.cr-22-0031
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发表时间：
2022-08-10
期刊：
影响因子：
--
通讯作者：
Nonogi, Hiroshi
中科院分区：
文献类型：
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作者：
Kojima, Sunao;Yamamoto, Takeshi;Kikuchi, Migaku;Hanada, Hiroyuki;Mano, Toshiaki;Nakashima, Takahiro;Hashiba, Katsutaka;Tanaka, Akihito;Yamaguchi, Junichi;Matsuo, Kunihiro;Nakayama, Naoki;Nomura, Osamu;Matoba, Tetsuya;Tahara, Yoshio;Nonogi, Hiroshi
关键词：
背景资料：在日本，通常在心肌梗死（MI）的急性期向患者供氧，而无需进行氧饱和度监测。在这项研究中，我们通过综合来自疑似或确诊急性心肌梗死患者的随机对照试验（RCT）的证据，评估了辅助供氧治疗与环境空气相比对死亡率和心脏事件的影响。方法和结果：系统检索PubMed，查找2020年6月21日前以英文发表的全文RCT。 两名评审员独立筛选检索结果并评估偏倚风险。使用随机效应模型汇总每个结果的估计值。总共筛选了从PubMed检索到的2，086项研究。最后，分析了来自4项RCT的9项研究的7，322例患者。氧气组和环境空气组的住院死亡率分别为1.8%和1.6%（风险比[RR] 0.90; 95%置信区间[CI] 0.38-2.10]）;分别有0.8%和0.5%的患者发生复发性MI（RR 0.44; 95% CI 0.12-1.54），分别有1.5%和1.6%的患者发生心源性休克（RR 1.10; 95% CI 0.77-1.59]），分别有2.4%和2.0%的患者发生心脏骤停（RR 0.91; 95% CI 0.43-1.94）。结论：常规辅助供氧可能没有益处或有害，在MI急性期，常氧患者可能不需要高流量氧气。
Background: In Japan, oxygen is commonly administered during the acute phase of myocardial infarction (MI) to patients without oxygen saturation monitoring. In this study we assessed the effects of supplemental oxygen therapy, compared with ambient air, on mortality and cardiac events by synthesizing evidence from randomized controlled trials (RCTs) of patients with suspected or confirmed acute MI. Methods and Results: PubMed was systematically searched for full-text RCTs published in English before June 21, 2020. Two reviewers independently screened the search results and appraised the risk of bias. The estimates for each outcome were pooled using a random-effects model. In all, 2,086 studies retrieved from PubMed were screened. Finally, 7,322 patients from 9 studies derived from 4 RCTs were analyzed. In-hospital mortality in the oxygen and ambient air groups was 1.8% and 1.6%, respectively (risk ratio [RR] 0.90; 95% confidence interval [CI] 0.38–2.10]); 0.8% and 0.5% of patients, respectively, experienced recurrent MI (RR 0.44; 95% CI 0.12–1.54), 1.5% and 1.6% of patients, respectively, experienced cardiac shock (RR 1.10; 95% CI 0.77–1.59]), and 2.4% and 2.0% of patients, respectively, experienced cardiac arrest (RR 0.91; 95% CI 0.43–1.94). Conclusions: Routine supplemental oxygen administration may not be beneficial or harmful, and high-flow oxygen may be unnecessary in normoxic patients in the acute phase of MI.