Author + information
- Received January 22, 2018
- Revision received March 8, 2018
- Accepted April 10, 2018
- Published online August 20, 2018.
- David Sparv, PhDa,∗ (, )
- Robin Hofmann, MD, PhDb,
- Annika Gunnarsson, BScc,
- Stefan James, MD, PhDd,
- Camilla Hedberg, BSce,
- Jörg Lauermann, MDe,
- Petronella Torild, BScf,
- Elmir Omerovic, MD, PhDf,
- Kristina Bergström, BScg,
- Espen Haugen, MD, PhDh,
- Camilla Bergström, BSci,
- Rikard Linder, MD, PhDi,
- Pia Borg, BScj,
- Urban Haaga, BSck,
- Anneli Olsson, BScl,
- Elin Böving, BScm,
- Ollie Östlund, PhDn,
- Rebecca Rylance, MSca,
- Nils Witt, MD, PhDb,
- David Erlinge, MD, PhDa,
- for the DETO2X-SWEDEHEART Investigators
- aDepartment of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
- bDepartment of Clinical Science and Education, Division of Cardiology, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- cDepartment of Cardiology, Uppsala University Hospital, Uppsala, Sweden
- dDepartment of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
- eDepartment of Internal Medicine, Division of Cardiology, Ryhov Hospital, Jönköping, Sweden
- fDepartment of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- gDepartment of Cardiology, Gävle Sjukhus, Gävle, Sweden
- hDepartment of Cardiology, Sundsvall Regional Hospital, Sundsvall, Sweden
- iDepartment of Cardiology, Danderyd University Hospital, Stockholm, Sweden
- jSvensk PCI Värmland AB, Karlstad, Sweden
- kDepartment of Cardiology, Central Hospital Karlstad, Karlstad, Sweden
- lDepartment of Cardiology, Skane University Hospital, Lund, Sweden
- mDepartment of Cardiology, Södersjukhuset, Stockholm, Sweden
- nUppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
- ↵∗Address for correspondence:
Dr. David Sparv, Department of Cardiology, Lund University, Skane University Hospital, SE-221 85 Lund, Sweden.
Objectives In this substudy of the DETO2X-AMI (An Efficacy and Outcome Study of Supplemental Oxygen Treatment in Patients With Suspected Myocardial Infarction) trial, the authors aimed to assess the analgesic effect of moderate-flow oxygen supplementation in patients with suspected acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) and to study the effect of oxygen supplementation on the use of opiates and sedatives during PCI.
Background Routine oxygen in normoxemic patients with AMI does not provide clinical benefit. However, oxygen may relieve ischemic pain.
Methods Patients were randomly allocated to oxygen or ambient air according to the main study protocol. After PCI, peak level of pain during PCI was measured by the Visual Analogue Scale. The total amount of opiates and sedatives was reported.
Results A total of 622 patients were enrolled: 330 in the oxygen group and 292 in the ambient air group. There was no significant difference in peak level of pain (oxygen 4.0 [1.0 to 6.0] vs. air 3.0 [0.6 to 6.0]; p = 0.37), use of opiates (mg) (oxygen 0.0 [0.0 to 3.0] vs. air 0.0 [0.0 to 3.0]; p = 0.31), or use of sedatives between the groups (median [interquartile range]) (oxygen 2.5 [0.0 to 2.5] vs. air 2.5 [0.0 to 2.5]; p = 0.74).
Conclusions In the present study, the authors did not find any analgesic effect of routine oxygen as compared with ambient air, and no differences in the use of sedatives and opiates during PCI. Our results indicate that moderate-flow oxygen supplementation does not relieve pain in normoxemic patients with suspected AMI undergoing treatment with PCI and should thus not be used for this purpose.
Dr. Östlund has received grants from AstraZeneca and The Medicines Company. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 22, 2018.
- Revision received March 8, 2018.
- Accepted April 10, 2018.
- 2018 American College of Cardiology Foundation