Should oxygen be given in myocardial infarction?BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c3287 (Published 17 June 2010) Cite this as: BMJ 2010;340:c3287
- Dan Atar, professor and head of cardiology
- 1Department of Cardiology B, Oslo University Hospital Ullevål and Faculty of Medicine, University of Oslo, 0407 Oslo, Norway
A systematic review published this week found no evidence that giving inhaled oxygen to people with acute myocardial infarction improves pain and survival, and that it may even do harm.1 Undoubtedly the medical community will take note of such a conclusion, but are the results reliable and what do they mean for clinical practice?
The review identified three randomised controlled trials that compared giving air with giving oxygen in people with an acute myocardial infarction; 387 people were studied and 14 died. The pooled relative risk of death was 2.88 (95% confidence interval 0.88 to 9.39), and this risk was 3.03 (0.93 to 9.83) in an intention-to treat analysis. Pain was also not significantly different between the groups (pooled relative risk 0.97, 0.78 to 1.20).
Methodology was poor in all three of the analysed articles, however. Two studies were performed unblinded,2 3 one was reported …