Effects of hyperoxia on myocardial injury following cardioversion—A randomized clinical trial
| Autor: | Charles D. Deakin, Simon M. Jepsen, Nete Hornung, Kasper Adelborg, Bo Løfgren, Leif F. Bach, Anders S Schmidt, Hans Rickers, Kasper G Lauridsen |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Electric Countershock Myocardial Infarction Hyperoxia 030204 cardiovascular system & hematology Cardioversion Risk Assessment Statistics Nonparametric 03 medical and health sciences 0302 clinical medicine Copeptin Troponin T Interquartile range Internal medicine Atrial Fibrillation medicine Humans 030212 general & internal medicine Myocardial infarction Natriuretic Peptides Aged business.industry Oxygen Inhalation Therapy Atrial fibrillation Middle Aged Prognosis medicine.disease Oxygen Survival Rate Atrial Flutter Elective Surgical Procedures Anesthesia Room air distribution Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers Atrial flutter |
| Zdroj: | Glerup Lauridsen, K, Schmidt, A S, Adelborg, K, Bach, L F, Hornung, N, Jepsen, S M, Deakin, C D, Rickers, H J V H & Løfgren, B 2018, ' Effects of hyperoxia on myocardial injury following cardioversion-A randomized clinical trial ', American Heart Journal, vol. 196, pp. 97-104 . https://doi.org/10.1016/j.ahj.2017.10.006 |
| ISSN: | 0002-8703 |
| DOI: | 10.1016/j.ahj.2017.10.006 |
| Popis: | Background Oxygen has long been assumed beneficial for all ill and injured patients. However, hyperoxia may be harmful and aggravate myocardial injury such as that caused by myocardial infarction. We aimed to investigate if hyperoxia increases myocardial injury following direct current cardioversion compared with room air. Methods Patients undergoing elective biphasic cardioversion for atrial fibrillation or atrial flutter were randomized to receive room air or oxygen (10–15 L/min) during the procedure. The primary endpoint was the difference in high-sensitive Troponin I (hs-cTnI) and -T (hs-cTnT) measured 2 hours before and 4 hours after cardioversion. Secondary endpoints were differences in Copeptin and NT-pro-BNP. Results A total of 65 patients were randomized to high-flow oxygen (male: 71%, mean age 66.9 years) and 59 patients to room air (male: 80%, mean age 65.5 years). There was no difference in hs-cTnI between patients treated with oxygen compared to patients treated with room air (P = .09) and no significant difference for hs-cTnT, ratio 1.08 (95% CI: 0.99–1.18) (P = .09). Median hs-cTnI difference before and after cardioversion was 0.1 (interquartile range (IQR): −0.5 to 0.5) ng/L for the high-flow oxygen group and −0.3 (IQR: −1.1 to 0.4) ng/L for the room air group. There was no difference in Copeptin between patients treated with oxygen compared to room air (ratio 1.06 (95% CI: 0.89–1.27) (P = .51) or NT-pro-BNP (difference− 6.0 ng/L (95% CI: −78.5 to 66.6) P = .87). Conclusion Direct current cardioversion of atrial fibrillation/flutter with and without high-flow oxygen supplement was not associated with myocardial injury evaluated by high sensitive myocardial biomarkers. |
| Databáze: | OpenAIRE |
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