Trial DesignA randomized controlled trial of oxygen therapy in acute myocardial infarction Air Verses Oxygen In myocarDial infarction study (AVOID Study)
Section snippets
Background
Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide.1 In particular, many patients with CAD present with ST-elevation myocardial infarction (STEMI) as a result of acute thrombotic coronary artery occlusion. The optimal treatment for patients presenting with STEMI is reperfusion therapy either with primary percutaneous coronary intervention (PCI) or administration of a thrombolytic drug.2, 3
Current guidelines recommend additional treatments for patients with
Study sites
This study will be conducted by Ambulance Victoria in partnership with 12 major metropolitan hospitals in Melbourne, Australia. The Mobile Intensive Care Ambulances (MICA) of Ambulance Victoria are equipped with 12 lead electrocardiogram (ECG) capability and pulse-oximetry monitors and have significant experience in successfully conducting pre-hospital clinical trials in critically ill patients.21, 22 Ambulance Victoria, also has a Melbourne wide field triage 12-lead ECG program to detect STEMI
Data collection
A study coordinator will extract all relevant study data to a secure stand alone study database.
Summary
Despite inhaled oxygen therapy being a routine component of pre-hospital and in-hospital care for AMI, there is concern that rendering patients hyperoxic may increase myocardial infarct size and possibly lead to worse outcomes. This has led to international guidelines cautioning against the use of routine oxygen in normoxic patients with uncomplicated AMI. The AVOID study will be one of the first clinical trials in the modern era of pre-hospital ECG field triage and PPCI to investigate the role
Disclosures
Conflicts of Interest: None to declare.
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Cited by (53)
Hyperoxia and mortality in conventional versus extracorporeal cardiopulmonary resuscitation
2022, Journal of Critical CareConservative versus liberal oxygen therapy for acutely ill medical patients: A systematic review and meta-analysis
2021, International Journal of Nursing StudiesCitation Excerpt :Using the grading of recommendations, assessment, development, and evaluation summary of the evidence, the quality of evidence of primary outcome was high (eTable 3). Seventeen trials (NCT 00414726) (Ali et al., 2014; Asfar et al., 2017; Baekgaard et al., 2019; Barrot et al., 2020; Butler et al., 1987; Girardis et al., 2016; He et al., 2019; Hofmann et al., 2017; Jakkula et al., 2018; Panwar et al., 2016; Ranchord et al., 2012; Roffe et al., 2017; Ronning and Guldvog, 1999; Schietroma et al., 2016; Singhal et al., 2005; Stub et al., 2012) reported all-cause mortality at 30 days. There was no significant difference in all-cause mortality at 30 days between the conservative and liberal oxygen therapy group (risk ratio 1.09, 95% confidence intervals 0.98–1.22; I2=0%; Fig. 2).
Effects of intraoperative high versus low inspiratory oxygen fraction (FiO<inf>2</inf>) on patient's outcome: A systematic review of evidence from the last 20 years
2020, Anaesthesia Critical Care and Pain Medicine
Clinical Trial Registration: The AVOID study has been registered with clinicaltrials.gov (NCT01272713).
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Dr Stub and Dr Smith contributed equally to this manuscript.