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Critical IllnessPhase 3SAVE-O2NCT04534959

Strategy to Avoid Excessive Oxygen for Critically Ill Trauma Patients

A Phase 3 study testing Targeting Normoxemia (SpO2 90-96%; PaO2 60-100 mmHg) in people with Critical Illness and Wounds and Injury, run by University of Colorado, Denver at 8 sites in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The objective is to determine the effectiveness of a multimodal educational intervention to reduce supplemental oxygen use in critically injured patients. Investigators will also evaluate the safety and clinical effectiveness of the more targeted use of oxygen therapy. Read more about this study

Who is it for?
Ages 18 to 120 years
What is being tested?
Targeting Normoxemia (SpO2 90-96%; PaO2 60-100 mmHg)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
6,000 participants
Where
8 sitesUnited States
Study dates
15 Oct 2020to 30 Jun 2025
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 120 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Acutely injured patients who meet the criteria for entry into the state or national trauma registry
  • Admission to surgical/trauma ICU within 24 hours of hospital arrival

Who cannot join

  • Age <18 years
  • Prisoners
  • Known pregnancy
  • Transferred patients not admitted through the emergency department

Trial locations and contacts

8 sites in 1 country.

8 sites in 1 country

United States8 sites
  • University of Alabama-Birmingham Medical Center

    Birmingham, Alabama, 35294

  • University of Cincinnati Medical Center

    Cincinnati, Ohio, 45219

  • Denver Health

    Denver, Colorado, 80204

  • Brooke Army Medical Center

    Fort Sam Houston, Texas, 78234

  • The University of Texas Health Science Center at Houston

    Houston, Texas, 77030

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37232

  • University of Pittsburgh Medical Center

    Pittsburgh, Pennsylvania, 15224

  • Oregon Health and Sciences University

    Portland, Oregon, 97239

Other trials in United States

About this study

Official title: Strategy to Avoid Excessive Oxygen for Critically Ill Trauma Patients (SAVE-O2)

The objective is to determine the effectiveness of a multimodal educational intervention to reduce supplemental oxygen use in critically injured patients. Investigators will also evaluate the safety and clinical effectiveness of the more targeted use of oxygen therapy.

Read the detailed description

Oxygen therapy has undisputed importance in the care of critically ill patients to prevent secondary complications related to hypoxemia. Although routine, the practice of excessive over-oxygenation may be harmful. An expert panel was convened and developed the strong consensus to target normoxemia at an oxygen saturation (SpO2) range of 90-96%, an arterial oxygen (PaO2) range of 60-100 mmHg (when applicable), and a fraction of inspired oxygen (FiO2) of 21% for mechanically ventilated patients or room air for nonmechanically ventilated patients.

Specific Aim: The purpose of this study is to determine the effectiveness of a multimodal educational intervention to reduce supplemental oxygen use in critically injured patients. Investigators will also evaluate the safety and clinical effectiveness of the more targeted use of oxygen therapy.

Hypotheses: Clinical efforts to through a multimodal educational intervention will:

  1. Improve the proportion of time spent within target normoxemia thresholds (oxygen saturation [SpO2] 90-96% and/or arterial oxygen [PaO2] 60-100 mmHg [when applicable]
  2. Limit use of excessive supplemental oxygen
  3. Reduce exposure to hyperoxemia without a substantive increase in hypoxemic episodes or adverse effects
Being tested
Targeting Normoxemia (SpO2 90-96%; PaO2 60-100 mmHg)
Keywords
hypoxia, hyperoxia, trauma, burn, critical illness, supplemental oxygen, oxygenation, SpO2, PaO2, FiO2, normoxia, hypoxemia, normoxemia, hyperoxemia
Medical subject headings
Critical Illness, Wounds and Injuries, Disease Attributes, Pathologic Processes, Hypoxia, Hyperoxia, Burns

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Targeting Normoxemia (SpO2 90-96%; PaO2 60-100 mmHg)Other

    Post-implementation of targeted normoxemia through oxygen titration for individual patients. Interventions for treatment of hypoxemia will follow usual local practice. Interventions for treatment of hyperoxemia (SpO2 >96% or PaO2 >100 mmHg) will involve down titration of FiO2 (or supplemental oxygen for non-mechanically ventilated patients) within a time frame based on local site preferences-typically in increments of no greater than 0.10 until goal oxygenation in the normoxemia range is achieved (including room air [no supplemental oxygen] for non-mechanically ventilated patients).

Study groups in NCT04534959
Study groupRoleWhat they receive
Pre-ImplementationNo interventionThe control (pre-implementation) group will be trauma patients admitted to the surgical/trauma ICU during the site's control period of the stepped-wedge implementation process (up to 22 months).
Post-Implementation Targeting Normoxemia in Trauma ICUExperimentalThe intervention (post-implementation) group will be patients admitted to the surgical/trauma ICU during the targeted normoxemia intervention period of the stepped-wedge implementation process (up to 25 months).
Receives: Other: Targeting Normoxemia (SpO2 90-96%; PaO2 60-100 mmHg)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Supplemental Oxygen Free Days (SOFD)

    Number of days alive and not on supplemental oxygen during the index hospitalization (0 days [worst outcome] to 28 days [best outcome])

    Measured: up to 28 days

Secondary outcomes (16)
  1. Hospital-Free Days to day 90 (HFD90)

    Number of days alive and outside the hospital (0 days [worst outcome] to 90 days [best outcome])

    Measured: up to 90 days

  2. In-hospital Mortality to day 90

    Dichotomous vital status (survived or died) at hospital discharge or day 90, whichever is first

    Measured: up to 90 days

  3. Time to Mortality to day 90

    Vital status and date of death censored at hospital discharge or day 90, whichever is first

    Measured: up to 90 days

  4. Ventilator Free Day (VFD) to day 28

    Ventilator Free Days = Days off ventilator (0 VFD [worst outcome] to 28 VFD [best outcome])

    Measured: up to 28 days

  5. Time to Room Air

    Duration of supplemental oxygen (FiO2 = 0.21 or room air)

    Measured: up to 90 days

  6. Glasgow Outcome Score (GOS)

    Patient will be assessed at hospital discharge with one of the following five categories: Death, Persistent Vegetative State, Severe Disability, Moderate Disability, Low Disability

    Measured: up to 90 days

  7. Discharge Disposition

    Defined as home (return to prior level of care) or facility (e.g., acute rehab, skilled nursing facility)

    Measured: up to 90 days

  8. Amount of Supplemental Oxygen Administered

    Total estimated oxygen volume while in the ICU after hospital arrival

    Measured: up to 90 days

  9. Duration of Time on Normoxemia Protocol Target

    Defined as SpO2 90-96% or receiving no supplemental oxygen (FiO2 0.21 or room air) while in the ICU

    Measured: up to 90 days

  10. Proportion of Participants Receiving High Levels of Supplemental Oxygen

    FiO2>0.40 or >4 liters per minute for >2 hours while in the ICU [excludes time in the operating room]

    Measured: up to 90 days

  11. Duration of Time receiving High Levels of Supplemental Oxygen

    FiO2>0.40 or >4 liters per minute while in the ICU

    Measured: up to 90 days

  12. Duration of Time Receiving No Supplemental Oxygen

    FiO2 0.21 or room air while in the ICU

    Measured: up to 90 days

  13. Incidence of Hypoxemic Event (SpO2<88%)

    SpO2 saturation below 88% while in the ICU

    Measured: up to 28 days

  14. Duration of Hypoxemic Events (SpO2<88%)

    SpO2 saturation below 88% while in the ICU

    Measured: up to 90 days

  15. incidence of Hyperoxemic Event (SpO2>96%)

    SpO2 saturation above 96% while in the ICU

    Measured: up to 90 days

  16. Duration of Hyperoxemic Event (SpO2>96%)

    SpO2 saturation above 96% while in the ICU

    Measured: up to 90 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Sep 2020
  2. Study start15 Oct 2020
  3. Primary completion15 Nov 2022
  4. Study completion30 Jun 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
6,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04534959
Sponsor's protocol ID
19-2153
Acronym
SAVE-O2
Status last verified
Mar 2025
First submitted
25 Aug 2020
Last updated
2 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Leverve XM. To cope with oxygen: a long and still tumultuous story for life. Crit Care Med. 2008 Feb;36(2):637-8. doi: 10.1097/CCM.0B013E31816296AD. No abstract available.

    PubMed 18216624
  • Damiani E, Adrario E, Girardis M, Romano R, Pelaia P, Singer M, Donati A. Arterial hyperoxia and mortality in critically ill patients: a systematic review and meta-analysis. Crit Care. 2014 Dec 23;18(6):711. doi: 10.1186/s13054-014-0711-x.

    PubMed 25532567
  • Panwar R, Capellier G, Schmutz N, Davies A, Cooper DJ, Bailey M, Baguley D, Pilcher V, Bellomo R. Current oxygenation practice in ventilated patients-an observational cohort study. Anaesth Intensive Care. 2013 Jul;41(4):505-14. doi: 10.1177/0310057X1304100412.

    PubMed 23808511
  • Suzuki S, Eastwood GM, Peck L, Glassford NJ, Bellomo R. Current oxygen management in mechanically ventilated patients: a prospective observational cohort study. J Crit Care. 2013 Oct;28(5):647-54. doi: 10.1016/j.jcrc.2013.03.010. Epub 2013 May 15.

    PubMed 23683560
  • Rachmale S, Li G, Wilson G, Malinchoc M, Gajic O. Practice of excessive F(IO(2)) and effect on pulmonary outcomes in mechanically ventilated patients with acute lung injury. Respir Care. 2012 Nov;57(11):1887-93. doi: 10.4187/respcare.01696. Epub 2012 May 15.

    PubMed 22613692
  • Parke RL, Eastwood GM, McGuinness SP; George Institute for Global Health; Australian and New Zealand Intensive Care Society Clinical Trials Group. Oxygen therapy in non-intubated adult intensive care patients: a point prevalence study. Crit Care Resusc. 2013 Dec;15(4):287-93.

    PubMed 24289510
  • Iscoe S, Beasley R, Fisher JA. Supplementary oxygen for nonhypoxemic patients: O2 much of a good thing? Crit Care. 2011;15(3):305. doi: 10.1186/cc10229. Epub 2011 Jun 30.

    PubMed 21722334
  • Panwar R, Young P, Capellier G. Conservative oxygen therapy in mechanically ventilated patients. Crit Care Med. 2014 Sep;42(9):e630-1. doi: 10.1097/CCM.0000000000000439. No abstract available.

    PubMed 25126814
  • de Graaff AE, Dongelmans DA, Binnekade JM, de Jonge E. Clinicians' response to hyperoxia in ventilated patients in a Dutch ICU depends on the level of FiO2. Intensive Care Med. 2011 Jan;37(1):46-51. doi: 10.1007/s00134-010-2025-z. Epub 2010 Sep 28.

    PubMed 20878146
  • Girardis M, Busani S, Damiani E, Donati A, Rinaldi L, Marudi A, Morelli A, Antonelli M, Singer M. Effect of Conservative vs Conventional Oxygen Therapy on Mortality Among Patients in an Intensive Care Unit: The Oxygen-ICU Randomized Clinical Trial. JAMA. 2016 Oct 18;316(15):1583-1589. doi: 10.1001/jama.2016.11993.

    PubMed 27706466
  • de Jonge E, Peelen L, Keijzers PJ, Joore H, de Lange D, van der Voort PH, Bosman RJ, de Waal RA, Wesselink R, de Keizer NF. Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients. Crit Care. 2008;12(6):R156. doi: 10.1186/cc7150. Epub 2008 Dec 10.

    PubMed 19077208
  • Pannu SR. Too Much Oxygen: Hyperoxia and Oxygen Management in Mechanically Ventilated Patients. Semin Respir Crit Care Med. 2016 Feb;37(1):16-22. doi: 10.1055/s-0035-1570359. Epub 2016 Jan 28.

    PubMed 26820270
  • Kallet RH, Branson RD. Should Oxygen Therapy Be Tightly Regulated to Minimize Hyperoxia in Critically Ill Patients? Respir Care. 2016 Jun;61(6):801-17. doi: 10.4187/respcare.04933.

    PubMed 27235315
  • Hafner S, Beloncle F, Koch A, Radermacher P, Asfar P. Hyperoxia in intensive care, emergency, and peri-operative medicine: Dr. Jekyll or Mr. Hyde? A 2015 update. Ann Intensive Care. 2015 Dec;5(1):42. doi: 10.1186/s13613-015-0084-6. Epub 2015 Nov 19.

    PubMed 26585328
  • Helmerhorst HJ, Roos-Blom MJ, van Westerloo DJ, de Jonge E. Association Between Arterial Hyperoxia and Outcome in Subsets of Critical Illness: A Systematic Review, Meta-Analysis, and Meta-Regression of Cohort Studies. Crit Care Med. 2015 Jul;43(7):1508-19. doi: 10.1097/CCM.0000000000000998.

    PubMed 25855899

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Targeting Normoxemia (SpO2 90-96%; PaO2 60-100 mmHg) in people with Critical Illness and Wounds and Injury, run by University of Colorado, Denver at 8 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 2 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Supplemental Oxygen Free Days (SOFD) (time frame: up to 28 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04534959, which also lists 40 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Apr 2025.

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