Oxygen causing harm?

[BushyFromOz]

They've been enrolling patients for a couple of years in your neck of the woods; any news on when they have all the patients they need?

I'm sure it'll be taken into account, but be curious to see how far they break down and differentiate the different MI's; just based on location and time, or will it be based on TIMI flow? Or something else?

I dunno, we get an email about it every few months through work about how far along they are in enrollment etc, and i think we had one recently. If i remember, ill have a look tomorrow.

I have no idea of the methodology, but i do remember seeing its methodology in a register of trials somewhere, that was ages ago though

[BushyFromOz]

They've been enrolling patients for a couple of years in your neck of the woods; any news on when they have all the patients they need?

I'm sure it'll be taken into account, but be curious to see how far they break down and differentiate the different MI's; just based on location and time, or will it be based on TIMI flow? Or something else?

Wouldn't you know, came into work today and there is a press release about the AVOID trial. Enrollments have obviously ceased and they are awaiting publication, but O2 in MI appears to be .....wait for it.....bad.....

http://www.ambulance.vic.gov.au/About-Us/Media-Centre/News/20141120-Oxygen-causes-harm-says-landmark-heart-attack-study.html

[triemal04]

Not super surprising; if they don't need O2, don't give them O2.

I really want to see the full study though, be interesting what adverse outcome they were seeing, what they were measuring, why it wasn't related to something else, and so forth. If there actually were true detrimental events that can be conclusively (or at least with a high degree of certainty) shown to have been caused by O2, that might have a better effect than just telling people it's not needed and "might" be a problem down the road.

Cool.

[triemal04]

http://www.cardiosource.org/science-and-quality/clinical-trials/a/avoid.aspx?WT.mc_id=Twitter

The link to the slides on the right has most of the actual study in it.

Definetly food for thought; while the people who got O2 had a larger infarct and more adverse events (including another MI), they actually had a LOWER mortality at both discharge, and 6 months. Hmmm...

I'd like to know why they choose 8lpm by facemask instead of 2-4 by nasal cannula. It doesn't make much sense; even the authors admit that what they did isn't a standard therapy.

[BushyFromOz]

I'm not sure triemal. this has been going for a few years obviously. We used to have these weird little 02 regulators that had a fixed 8l/min flow. they were kind of a legacy item I guess, and it wasn't an issue until the hyperoxia = bad really started to get investigated, so it could be an equipment limitation from a few years back when "high flow and go" was the standard

[Levi]

http://www.cardiosource.org/science-and-quality/clinical-trials/a/avoid.aspx?WT.mc_id=Twitter

The link to the slides on the right has most of the actual study in it.

Definetly food for thought; while the people who got O2 had a larger infarct and more adverse events (including another MI), they actually had a LOWER mortality at both discharge, and 6 months. Hmmm...

I'd like to know why they choose 8lpm by facemask instead of 2-4 by nasal cannula. It doesn't make much sense; even the authors admit that what they did isn't a standard therapy.

There was no difference in mortality, just FYI.

[triemal04]

Well...there was actually. Whether or not you want to call it significant, or if it was actually due to the trial and not random is certainly open to debate, but a 1.8%/4.5% mortality rate and 3.8%/5.9% rate was still found.

[ERDoc]

I can't pull up the actual study, but are those results statistically significant?

[triemal04]

Meh...if you look at the p-values they're high, especially when looking at the 6-month mortality, though less when looking at time of discharge.

[ERDoc]

So really, you can't make any conclusions based on the data. Sounds like we need a study with better power. Do you have an up to date link for the study?