title: Oxygen in the Setting of Acute Myocardial Infarction: Is It Really a Breath of Fresh Air?
abstract: BACKGROUND
  Supplemental oxygen has been used in the setting of acute myocardial infarction (AMI). Once an official recommendation in the guidelines for the management of acute ST-segment elevation myocardial infarction, it is now mentioned as an intervention to be considered. Data for the use of supplemental oxygen or AMI are limited, and some data have suggested associated harm.
  
  
  METHODS
  We performed a systematic review of the literature and a subsequent meta-analysis of the data to determine the effect of high concentration oxygen versus titrated oxygen or room air in the setting of AMI. The following end points were studied: in-hospital mortality, opiate use, percentage of infarcted myocardium by magnetic resonance imaging (MRI), and mass of infarcted myocardium by MRI.
  
  
  RESULTS
  No significant difference was noted with end points when comparing those randomized to high-concentration oxygen versus those randomized to titrated oxygen or room air in the setting of AMI. No significant publication bias was identified although this could not be assessed for all end points.
  
  
  CONCLUSIONS
  High-concentration oxygen may not offer any benefit when compared to titrated oxygen or room air. A large, randomized trial is warranted to further delineate these differences with respect to multiple end points.
authors.affiliation: Children's Hospital of Wisconsin/Medical College of Wisconsin, Department of Cardiology, Milwaukee, WI, USA loomba.rohit@gmail.com.
authors.forename: Rohit S
authors.initials: RS
authors.lastname: Loomba
authors.affiliation: Rush University Medical Center, Department of Cardiology, Chicago, IL, USA.
authors.forename: Karan
authors.initials: K
authors.lastname: Nijhawan
authors.affiliation: Creighton University Medical Center, Department of Cardiology, Omaha, NE, USA.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Aggarwal
authors.affiliation: Chicago Medical School, Chicago, Department of Cardiology, IL, USA.
authors.forename: Rohit R
authors.initials: RR
authors.lastname: Arora
mesh_terms: D004562:Electrocardiography / Q000379:methods; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D010100:Oxygen / Q000008:administration & dosage; D010102:Oxygen Inhalation Therapy / Q000379:methods* / Q000401:mortality
chemical_list: D010100:Oxygen
keywords: heart attack; hyperoxia; myocardial infarction; oxygen; oxygen saturation; oxygen tension