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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Thursday, March 2, 2023

HF O2, ACS and mortality

REBEL Cast Ep114 - By Salim Rezaie - March 02, 2023
Paper: Stewart, RAH et al. High Flow Oxygen and Risk of Mortality in Patients with a Suspected Acute Coronary Syndrome: Pragmatic, Cluster Randomised, Crossover Trial. BMJ 2021. PMID: 33653685
Clinical Question: Is there an association between high flow supplementary oxygen and 30-day mortality in patients presenting with a suspected acute coronary syndrome (ACS)?
Author Conclusion: “In a large patient cohort presenting with suspected ACS, high flow oxygen was not associated with an increase or decrease in 30 day mortality.”
Clinical Take Home Point: Unfortunately, this is a completely flawed trial that did not achieve any difference in SpO2 between groups (98% vs 96%), included >50% of patients without ACS, and had no granular details (troponin levels, echo findings, quality of life, treatments given between groups). Until further better evidence is produced, I recommend continuing to not use oxygen in patients with ACS who are normoxemic.