Heart Institute, Hadassah Hebrew University Medical Center, PO Box 12000, Jerusalem, Israel.
Eur Heart J. 2013 Jun;34(22):1630-5. doi: 10.1093/eurheartj/eht110. Epub 2013 Apr 3.
Oxygen supplementation is a standard treatment for all patients who present with acute coronary syndrome, regardless of oxygen saturation levels. Most of the data regarding the function of oxygen in myocardial infarction is based on a limited number of basic and clinical studies. We performed a systematic literature review that explores the basic and clinical data on the function of oxygen in ischaemic heart disease and myocardial infarction. This review discusses many aspects of oxygen treatment: (i) basic studies on the effects of oxygen in ischaemia and the potential cardiovascular effects of oxygen metabolites; (ii) clinical trials that have assessed the value of inhaled oxygen, supersaturated oxygen, and intracoronary injection of hyperoxaemic solutions in myocardial infarction; and (iii) the haemodynamic effects of oxygen in various clinical scenarios and its direct effects on the coronary vasculature. Our findings suggest that there are conflicting data on the effects of oxygen treatment. Further, the potential harmful effects of oxygen must be considered, particularly in myocardial infarction. These findings question the current guidelines and recommendations and emphasize the need for large clinical trials.
氧疗是所有出现急性冠脉综合征患者的标准治疗方法，无论其血氧饱和度水平如何。关于氧在心肌梗死中的作用的大多数数据都是基于为数不多的基础和临床研究。我们进行了一项系统的文献综述，探讨了关于氧在缺血性心脏病和心肌梗死中作用的基础和临床数据。这篇综述讨论了氧治疗的许多方面：（i）氧在缺血中的作用的基础研究以及氧代谢物的潜在心血管作用；（ii）评估吸入氧、过饱和氧和冠状动脉内注射高氧溶液在心肌梗死中的价值的临床试验；（iii）不同临床情况下氧的血流动力学作用及其对冠状动脉血管的直接作用。我们的研究结果表明，氧治疗效果的数据存在矛盾。此外，必须考虑氧的潜在有害作用，尤其是在心肌梗死中。这些发现对当前的指南和建议提出了质疑，并强调需要进行大型临床试验。
