Administering Oxygen In Patients Suffering From Myocardial Infarction

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Myocardial infarction is defined by the ischemia of the myocardial tissue. It is commonly the consequence of the blockage of a coronary artery following the rupture of a cholesterol plaque. As the heart may no longer be able to maintain a normal output, organs may suffer from hypoxia and the patient might need to be supplemented in oxygen in order to preserve normal oxygen saturation level. Most patients suffering from this disease receive oxygen in ambulances or emergency departments even if they are normoxic in an attempt to reduce further complications, pain or mortality. This essay will analyze studies performed in different countries and hospitals, and analyze their findings to demonstrate if administering oxygen in a routine manner decreases the mortality of normoxic patients suffering from myocardial infarction.

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Kirschner and Hunter (2019,) realized a recent study called DETO2X-AMI among thirty-five Swedish hospitals. Normoxemic (saturation of oxygen superior to 90 percent) patients who may have myocardial infarction received oxygen therapy or ambient air. The authors concluded that there was no difference in the outcomes regarding mortality or rehospitalization caused by heart failure at one year. Additionally, Loomba and Al. (2016, pp. 143–149) studied existing literature to define the impacts of high oxygen levels in comparison with titrated oxygen and ambient air for patients suffering from this disease. After reviewing five studies, they claimed that administering high levels of oxygen did have any positive impact and their findings showed similar in-hospital mortality for all patients. The intrahospital ratio of mortality for patients receiving a high concentration of oxygen was four percent and three percent for patients who were not administered any oxygen. The dissimilarity was established to be non-significant. Notwithstanding, as mentioned by the authors, more patients in each group would have been necessary to establish a meaningful difference in intrahospital mortality.

In another article from Hofmann and Al., delivering oxygen to patients who presented with myocardial infarctions and normal oxygen levels did not ameliorate mortality. Moreover, the ratio of death at thirty days and a year was comparable between patients who were administered oxygen and ambient air. A limitation of this study, as mentioned by Kulkarni (2018, p.nd), is the important percentage of patients who were not finally diagnosed with myocardial infarction. Finally, as reported by the authors of the AVOID trial (2010, cited in Shah 2019), administering oxygen had no benefit on mortality at six months.

In conclusion, these recent scientific articles suggest that there are no benefits to routinely administer oxygen to patients having myocardial infarction if not clinically required. Additional research including a higher amount of patients in every group would be beneficial. Furthermore, ‘oxygen is not a harmless “drug”‘. A new study suggested that routine administration of oxygen might have adverse impacts on mortality as shown by Yun Kim and Al. It is therefore essential that health care workers such as registered nurses do not base their practice with oxygen administration on habits and routine but on scientific and updated evidence. They must ensure that the best quality care is performed in terms of oxygen treatment among patients having myocardial infarction and question medical officers if needed.   

16 December 2021

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