{"id":"7ab15e4c596a","type":"article","url":"https://hartvaat.nl/2017/09/28/zuurstoftherapie-bij-vermoedelijk-acuut-myocardinfarct-nejm-deto2x-ami/","title":"Zuurstoftherapie bij vermoedelijk acuut myocardinfarct: NEJM DETO2X-AMI","title_en":"Oxygen Therapy in Suspected Acute Myocardial Infarction.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts"],"tags":["acuut-hartfalen","harttransplantatie","myocardinfarct","nstemi","slaapapneu"],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa1706222","source_url":"https://doi.org/10.1056/NEJMoa1706222","authors":["Robin Hofmann","Stefan K James","Tomas Jernberg","Bertil Lindahl","David Erlinge","Nils Witt","Gabriel Arefalk","Mats Frick","Joakim Alfredsson","Lennart Nilsson","Annica Ravn-Fischer","Elmir Omerovic","Thomas Kellerth","David Sparv","Ulf Ekelund","Rickard Linder","Mattias Ekström","Jörg Lauermann","Urban Haaga","John Pernow","Ollie Östlund","Johan Herlitz","Leif Svensson"],"significance":9,"published":"2017-09-28","source_date":"2017-09-28","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/"],"congress":"","summary_en":"The DETO2X-AMI trial showed that routine supplemental oxygen therapy did not reduce 1-year mortality in patients with suspected acute MI who were not hypoxemic at baseline. This large registry-based trial overturned decades of routine oxygen use in acute coronary care.","created":"2026-07-03T10:26:54Z","updated":"2026-07-03T18:38:35Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"NEJM DETO2X-AMI-trial die aantoonde dat routinematige zuurstoftherapie bij vermoedelijk acuut MI zonder hypoxie geen voordeel biedt. Veranderde wereldwijd de ambulanceprotocollen.","abstract_original":"BACKGROUND: The clinical effect of routine oxygen therapy in patients with suspected acute myocardial infarction who do not have hypoxemia at baseline is uncertain. METHODS: In this registry-based randomized clinical trial, we used nationwide Swedish registries for patient enrollment and data collection. Patients with suspected myocardial infarction and an oxygen saturation of 90% or higher were randomly assigned to receive either supplemental oxygen (6 liters per minute for 6 to 12 hours, delivered through an open face mask) or ambient air. RESULTS: A total of 6629 patients were enrolled. The median duration of oxygen therapy was 11.6 hours, and the median oxygen saturation at the end of the treatment period was 99% among patients assigned to oxygen and 97% among patients assigned to ambient air. Hypoxemia developed in 62 patients (1.9%) in the oxygen group, as compared with 254 patients (7.7%) in the ambient-air group. The median of the highest troponin level during hospitalization was 946.5 ng per liter in the oxygen group and 983.0 ng per liter in the ambient-air group. The primary end point of death from any cause within 1 year after randomization occurred in 5.0% of patients (166 of 3311) assigned to oxygen and in 5.1% of patients (168 of 3318) assigned to ambient air (hazard ratio, 0.97; 95% confidence interval [CI], 0.79 to 1.21; P=0.80). Rehospitalization with myocardial infarction within 1 year occurred in 126 patients (3.8%) assigned to oxygen and in 111 patients (3.3%) assigned to ambient air (hazard ratio, 1.13; 95% CI, 0.88 to 1.46; P=0.33). The results were consistent across all predefined subgroups. CONCLUSIONS: Routine use of supplemental oxygen in patients with suspected myocardial infarction who did not have hypoxemia was not found to reduce 1-year all-cause mortality. (Funded by the Swedish Heart-Lung Foundation and others; DETO2X-AMI ClinicalTrials.gov number, NCT01787110 .)."}