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dc.contributor.authorNehme, Z.
dc.contributor.authorStub, D.
dc.contributor.authorBernard, S.
dc.contributor.authorStephenson, M.
dc.contributor.authorBray, Janet
dc.contributor.authorCameron, P.
dc.contributor.authorMeredith, I.
dc.contributor.authorBarger, B.
dc.contributor.authorEllims, A.
dc.contributor.authorTaylor, A.
dc.contributor.authorKaye, D.
dc.contributor.authorSmith, K.
dc.date.accessioned2017-01-30T11:10:33Z
dc.date.available2017-01-30T11:10:33Z
dc.date.created2016-03-29T19:30:12Z
dc.date.issued2016
dc.identifier.citationNehme, Z. and Stub, D. and Bernard, S. and Stephenson, M. and Bray, J. and Cameron, P. and Meredith, I. et al. 2016. Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction. Heart. 102 (6): pp. 444-451.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/9109
dc.identifier.doi10.1136/heartjnl-2015-308636
dc.description.abstract

Objective Supplemental oxygen therapy may increase myocardial injury following ST-elevation myocardial infarction (STEMI). In this study, we aimed to evaluate the effect of the dose and duration of oxygen exposure on myocardial injury after STEMI. Methods Descriptive analysis of data from a multicentre, prospective, randomised, controlled trial of 441 patients with STEMI randomised to supplemental oxygen therapy or room air breathing. The primary endpoint was myocardial infarct size as aeed by cardiac biomarkers, troponin (cTnI) and creatine kinase (CK). Oxygen therapy was commenced by paramedics, and continued for up to 12 h postintervention in hospital. Supplemental oxygen exposure was calculated as the area under the dose×time curve for oxygen administration over the first 12 h, and then aeed for its aociation with cTnI/CK release using multivariable linear regreion. Results The median supplemental oxygen exposure was 1746 L (IQR: 960-2858). After adjustment for potential confounders, every 100 L increase in oxygen exposure in the first 12 h was aociated with a 1.4% (95% CI 0.6% to 2.2%, p<0.001) and 1.2% (95% CI 0.7% to 1.8%, p<0.001) increase in the mean peak cTnI and CK, respectively. Excluding patients who developed cardiogenic shock, recurrent myocardial infarction or desaturations (SpO2<94%) during admiion, every 100 L increase in oxygen exposure was aociated with a 1.2% (95% CI 0.2% to 2.1%, p=0.01) and 1.0% (95% CI 0.3% to 1.7%, p=0.003) increase in the mean peak cTnI and CK, respectively. The median supplemental oxygen exposure of 1746 L would result in a 21% (95% CI 3% to 37%) increase in infarct size according to the cTnI profile. Conclusions Supplemental oxygen exposure in the first 12 h after STEMI was aociated with a clinically significant increase in cTnI and CK release.

dc.publisherBMJ Publishing Group
dc.titleEffect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction
dc.typeJournal Article
dcterms.source.volume102
dcterms.source.number6
dcterms.source.startPage444
dcterms.source.endPage451
dcterms.source.issn1355-6037
dcterms.source.titleHeart
curtin.departmentSchool of Nursing and Midwifery
curtin.accessStatusFulltext not available


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