Shifting Baseline of Continuous Thermodilution

Q: What is the clinical evidence from this study?

Study design: Letter. Intervention: Intracoronary supersaturated oxygen (SSO2).

Q: What does this research mean for the field?

Reported increases in coronary blood flow during intracoronary supersaturated oxygen infusion conflict with established evidence of hyperoxia-induced vasoconstriction and may reflect continuous thermodilution artifacts. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Pitt O. Lim

doi:10.1016/j.jaccas.2026.109316

September 1, 2026JACC Case ReportsOpen Access

Shifting Baseline of Continuous Thermodilution

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Why the study?

Does intracoronary supersaturated oxygen (SSO2) improve coronary flow and microvascular resistance following stenting in STEMI patients?

Key Points

Critique reported vasodilatation and increased coronary flow during intracoronary supersaturated oxygen therapy by evaluating potential thermodilution artifacts against clinical evidence.
Critical review of continuous thermodilution flow measurements during intracoronary supersaturated oxygen administration.
Comparison of reported hyperemic responses with physiological outcomes from coronary artery bypass grafting and acute myocardial infarction trials.
Reported hyperemic flow increases contradict established evidence showing that supraphysiological oxygenation causes vasoconstriction and impairs cardiac function.
Prior intracoronary oxygen delivery trials failed to demonstrate noticeable reductions in infarct size or improvements in 30-day outcomes.

Structured PICO

Does intracoronary supersaturated oxygen (SSO2) improve coronary flow and microvascular resistance following stenting in STEMI patients?

P

Population

Patients with ST-segment elevation myocardial infarction (STEMI) undergoing recanalization of a diffusely diseased infarct-related left anterior descending artery

I

Intervention

Intracoronary supersaturated oxygen (SSO2)

O

Outcome

Coronary flow and microvascular resistance measured by continuous and bolus thermodilutionsurrogate

Limitations

Divergence between continuous and bolus thermodilution results
Outlying baseline values for infusate and mixed temperatures
Biologically implausible supranormal coronary flow parameters

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Implication

This editorial highlights potential physiological implausibility and methodological flaws in reported data showing massive increases in coronary flow measured by continuous thermodilution following intracoronary supersaturated oxygen therapy.

Abstract

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Cite This Study

Pitt O. Lim (2026) reported a letter. Intracoronary supersaturated oxygen (SSO2) was evaluated.

synapsesocial.com/papers/6ace6e0db52af824ab02bc4e https://doi.org/10.1016/j.jaccas.2026.109316

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Shifting Baseline of Continuous Thermodilution

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Shifting Baseline of Continuous Thermodilution

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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