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Critical IllnessSAVE-O2 AINCT06374225

Strategy to Avoid Excessive Oxygen Using an Autonomous Oxygen Titration Intervention

A study testing Automated Titration (O2matic) in people with Critical Illness and Wounds and Injury, run by University of Colorado, Denver at 4 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial summary

This study is a multicenter randomized controlled trial to determine the effectiveness of a closed loop/autonomous oxygen titration system (O2matic PRO100) to maintain normoxemia (goal range SpO2 90-96%, target 93%) during the first 72 hours of acute injury or illness, compared to standard provider-driven methods… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Automated Titration (O2matic)
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
300 participants
Where
4 sitesUnited States
Study dates
29 Apr 2024to 9 Jan 2026
Phase
Interventional

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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 years or older
  • Hospitalized or will be hospitalized from Emergency Department for major trauma, burn, acute care surgery, or acute respiratory illness
  • Able to be randomized within 36 hours of hospital arrival
  • Receiving supplemental oxygen 1-10 liters per minute for documented or presumed hypoxemia (must be higher than baseline for those on chronic oxygen therapy)
  • Signed and dated informed consent from patient or legally authorized representative (LAR)

Who cannot join

  • Anticipated hospital discharge within 24 hours
  • Imminent plans to discontinue supplemental oxygen
  • Imminent plans to administer high flow nasal oxygen, non-invasive ventilation, or invasive mechanical ventilation
  • Clinical team unwilling or unable to follow the prescribed oxygen titration method in either randomized group
  • Known prisoner
  • Known pregnancy
  • Known contraindicated conditions for use of the PRO100 device: carbon monoxide poisoning, incapable of handling airway secretions, increased methemoglobin, cyanide poisoning, cluster headaches, undrained pneumothorax, sickle cell crisis, paraquat poisoning or a history of bleomycin poisoning, patients for whom the SpO2 signal is not stable

Trial locations and contacts

4 sites in 1 country.

United States4 sites
  • University of Colorado

    Aurora, Colorado, 80045

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37232

  • Oregon Health and Sciences University

    Portland, Oregon, 97239

  • Atrium Health Wake Forest Baptist Medical Center

    Winston-Salem, North Carolina, 27157

Other trials in United States

About this study

Official title: Strategy to Avoid Excessive Oxygen Using an Autonomous Oxygen Titration Intervention (SAVE-O2 AI)

This study is a multicenter randomized controlled trial to determine the effectiveness of a closed loop/autonomous oxygen titration system (O2matic PRO100) to maintain normoxemia (goal range SpO2 90-96%, target 93%) during the first 72 hours of acute injury or illness, compared to standard provider-driven methods (manual titration with SpO2 target of 90-96%).

Read the detailed description

Ensuring adequate oxygenation is a primary goal in surgical and medical patients to treat and prevent morbidity associated with hypoxemia. However, excessive oxygen administration resulting in hyperoxemia is common, leading to unnecessary utilization of supplemental oxygen, which is a particularly limited resource in austere settings. Building on the previous Strategy to Avoid Excessive Oxygen (SAVE-O2) clinical trials1 (Trauma: NCT045349559; Burn: NCT04534972), the investigators seek to determine effective strategies to implement a targeted normoxemia approach to avoid both hyperoxemia and hypoxemia and reduce supplemental oxygen use, using the PRO100 closed loop/autonomous oxygen system. This research is critical for both military and civilian care settings in determining the effectiveness of an autonomous oxygen system to use to 1) reduce harm associated with both hypoxemia and hyperoxemia and 2) reduce excess use of oxygen.

Objectives: the investigators propose the following two objectives:

Determine the effectiveness of an autonomous oxygen titration system to improve normoxemia and reduce hypoxemia and hyperoxemia in acutely injured and ill patients receiving supplemental oxygen. The investigators will compare patient-hours spent in normoxemia (SpO2 90-96%), hypoxemia (SpO2 <88%), and hyperoxemia (SpO2 >96%) among patients randomized to autonomous vs manual oxygen titration.

Determine the impact of an autonomous oxygen titration system on overall utilization of supplemental oxygen. The investigators will compare the total volume of supplemental oxygen administered to patients randomized to autonomous vs manual oxygen titration during the 72-hour intervention period.

Hypothesis: The investigators hypothesize that the use of an autonomous oxygen titration system will be more effective at maintaining normoxemia and reducing time spent in hypoxemia/hyperoxemia than standard manual titration in non-mechanically ventilated patients and will reduce the overall use of supplemental oxygen.

Being tested
Automated Titration (O2matic)
Keywords
hypoxia, hyperoxia, burn, trauma, acute care surgery, acute respiratory illness, critical illness, supplemental oxygen, oxygenation, SpO2, PaO2, FiO2, normoxia, hypoxemia, hyperoxemia, normoxemia, autonomous, device
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.

  • Automated Titration (O2matic)Device

    The patient will receive supplemental oxygen titrated using an autonomous oxygen titration device. The patient will be monitored and vital signs documented by the site's usual SpO2 assessments, but oxygen titration will occur automatically through the O2matic PRO100 device during the intervention period, unless there is a safety concern. The SpO2 range programmed into the PRO100 is 92-94%. The acceptable SpO2 range for the protocol is 90-96%. If a patient requires >15lpm or other signs of advancing respiratory failure, they will be taken off the autonomous oxygen and transitioned to higher flow oxygen devices or mechanical ventilation per usual clinical care. If the patient is not receiving any supplemental oxygen per the autonomous titration, the clinical team may remove the oxygen delivery device from the patient, but the patient should remain connected to the PRO100 for the duration of the intervention period for data collection and to monitor for new supplemental oxygen needs.

Study groups in NCT06374225
Study groupRoleWhat they receive
Usual Care (Manual Titration)No interventionPatients randomized to the usual care arm will receive usual care, manual oxygen titration, removal of supplemental oxygen, and escalation per hospital protocol, based on the site's usual SpO2 assessments. The SpO2 monitor for the O2matic PRO100 will also be connected to the patient in observation mode for data collection purposes only (not used for titration decisions).
Intervention (Automated Titration)ExperimentalPatients randomized to the intervention arm will receive supplemental oxygen via nasal cannula (recommended up to 6 lpm) or face mask (recommended up to 15 lpm) and will have supplemental oxygen titrated using an autonomous oxygen titration system for the first 72 hours after randomization, or hospital discharge (whichever sooner).
Receives: Device: Automated Titration (O2matic)

What is being measured

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

  1. Percentage of Time Spent Within the Targeted Normoxemia Range

    The primary endpoint is percentage of time spent within the targeted normoxemia range, defined as an oxygen saturation (SpO2) of 90-96% (target 93%), as measured by continuous non-invasive pulse oximetry, during the first 72 hours after randomization, censored at hospital discharge, escalation to high flow nasal oxygen/mechanical ventilation, or death if prior to 72 hours.

    Measured: during first 72 hours after randomization, censored at hospital discharge, escalation to high flow nasal oxygen/mechanical ventilation, or death if prior to 72 hours.

Secondary outcomes (4)
  1. Percentage of Time Spent in Hypoxemia (SpO2<88%)

    Percentage of time spent in hypoxemia (SpO2 <88%) during the first 72 hours after randomization.

    Measured: during first 72 hours after randomization

  2. Percentage of Time Spent in Hyperoxemia (SpO2 >96%)

    Percentage of time spent in hyperoxemia (SpO2 >96%) during the first 72 hours after randomization.

    Measured: during first 72 hours after randomization

  3. Amount of Supplemental Oxygen Administered

    defined as total estimated oxygen volume during the first 72 hours after randomization.

    Measured: during first 72 hours after randomization

  4. Time to Room Air

    defined as the time from hospital presentation to the first episode of no supplemental oxygen (room air), censored at discharge or death.

    Measured: censored at day 28, discharge if before day 28, or death.

Timeline

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

  1. First posted18 Apr 2024
  2. Study start29 Apr 2024
  3. Primary completion7 Dec 2025
  4. Study completion9 Jan 2026

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
300 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06374225
Sponsor's protocol ID
23-0866
Acronym
SAVE-O2 AI
Status last verified
Sep 2026
First submitted
4 Apr 2024
Last updated
14 Oct 2026
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Douin DJ, Rice JD, Xiao M, Beaty L, Guo C, Withers C, Sullivan A, Anderson EL, Cheng AC, Banasiewicz MK, Semler MW, Lloyd BD, Maiga A, Gibbs KW, Stettler GR, Khan A, Sally MB, Wright FL, Aggarwal N, Bebarta VS, Ginde AA; SAVE-O2 AI Investigators. Statistical analysis plan for the Strategy to Avoid Excessive Oxygen using Autonomous Oxygen Titration Intervention (SAVE-O2 AI) trial: protocol. BMJ Open. 2026 Jan 28;16(1):e110739. doi: 10.1136/bmjopen-2025-110739.

    PubMed 41605593
  • Douin DJ, Rice JD, Xiao M, Beaty LE, Guo CJ, Withers C, Sullivan A, Anderson EL, Cheng AC, Banasiewicz MK, Semler MW, Lloyd BD, Maiga AW, Gibbs KW, Stettler GR, Khan A, Sally MB, Wright FL, Wiktor AJ, Aggarwal NR, Bebarta VS, Ginde AA; SAVE-O AI Investigators. Autonomous Oxygen Titration for Maintaining Normoxemia in Acutely Ill Adults: The SAVE-O2 AI Randomized Clinical Trial. JAMA Intern Med. 2026 Aug 3. doi: 10.1001/jamainternmed.2026.4023. Online ahead of print.

    PubMed 42546017

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