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VIEWPOINT

Revisiting the Role of Oxygen Therapy in Cardiac Patients

Penn State Heart and Vascular Institute, the Pennsylvania State University College of Medicine, the Milton S. Hershey Medical Center, Hershey, Pennsylvania

Manuscript received June 8, 2009; revised manuscript received April 14, 2010, accepted April 21, 2010.

^_* Reprint requests and correspondence: Dr. Lawrence I. Sinoway, Heart and Vascular Institute and Department of Medicine, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, 500 University Drive, Hershey, Pennsylvania 17033 (Email: lsinoway{at}hmc.psu.edu).

Over the past century, multiple studies lacking the precision of today's advanced technology provided conflicting data on the effects of oxygen therapy in normoxic cardiac patients. More importantly, no randomized, blinded, controlled studies have shown a benefit of such treatment. Yet the use of supplemental oxygen is widespread in cardiac patients. In these conditions, inadvertent hyperoxia commonly occurs because of concerns to ensure sufficient oxygenation and because hyperoxia is not perceived to be detrimental. In recent years, there has been mounting evidence demonstrating the potential adverse effects of hyperoxia on the cardiovascular system. In this report, we review data examining the effects of supplemental oxygen in normoxic patients with acute presentations of coronary artery disease. It is also the aim of this report to emphasize the point that oxygen therapy might have major adverse physiologic effects that must be considered when it is employed.

Key Words: CAD • hyperoxia • oxygen

Abbreviations and Acronyms   ACS = acute coronary syndromes   CBF = coronary blood flow   CBV = coronary blood velocity   CVR = coronary vascular resistance

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