P3705Pre-hospital routine oxygen supplement may do harm: insight from Tokyo CCU network database

Abstract

Background: Oxygen supplement for AMI patients have been addressed as one of initial treatments and done routinely. On the other hand, excessive supplement of oxygen was reported to have association with larger myocardial damage in AMI patients. AVOID study showed adverse effect of excessive oxygen for AMI patients in primary PCI era, however data are still few. Methods: This is a multicenter cohort study by using data of Tokyo CCU network. For investigating effect of oxygen supplement for AMI patients, we extracted STEMI patients in KillipIstate (not congestive state) whose data about oxygen supplement by paramedics, oxygen saturation at admission and peak serum creatinine kinese (CK) level are available from the database. (n=7080) Peak serum CK level and 30‐day mortality was assessed and compared between 2 groups with or without oxygen supplement. Results: The number of patients with or without oxygen supplement were 5479 and 1601, respectively. Patient characteristics were almost comparable except oxygen saturation, chronic kidney disease and time duration from onset to balloon. Oxygen saturation was significantly higher in patients with oxygen supplement (median 99% vs 98%, p<0.001), and about 40% of those were 100% saturated. Serum creatinine kinese level which reflected onset to door duration was lower in patients with oxygen supplement (median 171 mg/dL vs 238 mg/dL, p<0.001), however peak CK level was higher, conversely. (median 1804 mg/dL vs 1556 mg/dL, p<0.001) Multivariate linear regression analysis revealed that oxygen supplement had strong correlation with peak CK level. Conclusion: Routine oxygen supplement without hypoxia may increase myocardial damage in STEMI patients. (Table Presented).