Autonomous Oxygen Titration for Maintaining Normoxemia in Acutely Ill Adults: The SAVE-O 2 AI Randomized - Report - MDSpire
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Automated Oxygen Adjustment for Sustaining Normoxemia in Critically Ill Adults: Results from the SAVE-O 2 AI Trial

  • By

  • David J. Douin

  • John D. Rice

  • Mengli Xiao

  • Laurel E. Beaty

  • Claire J. Guo

  • Cori Withers

  • Amy Sullivan

  • Erin L. Anderson

  • Alex C. Cheng

  • Mary K. Banasiewicz

  • Matthew W. Semler

  • Bradley D. Lloyd

  • Amelia W. Maiga

  • Kevin W. Gibbs

  • Gregory R. Stettler

  • Akram Khan

  • Mitchell B. Sally

  • Franklin L. Wright

  • Arek J. Wiktor

  • Neil R. Aggarwal

  • Vikhyat S. Bebarta

  • Adit A. Ginde

  • SAVE-O AI Investigators

  • Laura G. Murphy

  • Erika V. Alor

  • Yvette R. Evans

  • Laura A. Aguilar-Marquez

  • Jessica Cwik

  • Katie Gray

  • Dagmawit Getachew

  • April Johnson

  • Jakea D. Johnson

  • Karen F. Miller

  • Tracy L. Morgan

  • Shannon K. Pugh

  • Edward T. Qian

  • Colleen Ratcliff

  • Sabrina A. Shipman

  • Adam Turner

  • Lakeysha C. Wiggins

  • Genesis Briceno

  • Aidan Flieger

  • Nola Iwasaki

  • Riya Mathew

  • Chloe K. Ouchida

  • Jose Pena

  • Edvinas Pocius

  • Emily Tribbet

  • Samantha Underwood

  • Heather L. Clark

  • Copeland Graham

  • Leigha Landreth

  • Lisa Parks

  • Darija Ward

  • October 1, 2026

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Clinical Report: Automated Oxygen Adjustment for Sustaining Normoxemia

Overview

The SAVE-O2 AI trial demonstrated that autonomous oxygen titration significantly increased the time hospitalized adults spent in the target normoxemia range (SpO2 90%-96%) and reduced the duration of hypoxemia compared to manual titration. This multicenter trial involved critically ill adults receiving supplemental oxygen across four US hospitals.

Background

Supplemental oxygen is crucial for preventing and managing hypoxemia in acutely ill patients, with inadequate oxygen delivery linked to high in-hospital mortality rates. Traditional methods of oxygen titration can leave patients vulnerable to fluctuations in oxygen saturation.

Data Highlights

OutcomeAutonomous TitrationUsual Care
Time in Normoxemia (SpO2 90%-96%)IncreasedDecreased
Time in Hypoxemia (SpO2 <88%)ReducedIncreased

Key Findings

  • Autonomous oxygen titration increased the proportion of time spent in the target SpO2 range of 90%-96%.
  • Participants in the autonomous group experienced reduced time in hypoxemia compared to those receiving usual care.
  • The trial was conducted across four diverse US tertiary care hospitals.
  • Patients included were those with acute respiratory illness, trauma, burns, or acute care surgery.
  • The O2matic PRO100 device was used for autonomous titration, adjusting oxygen flow based on pulse oximetry.

Clinical Implications

Clinicians may consider integrating autonomous oxygen titration systems into practice.

Conclusion

The SAVE-O2 AI trial evaluated the efficacy of autonomous oxygen titration in maintaining normoxemia in critically ill adults.

Related Resources & Content

  1. Kirton et al., JAMA Internal Medicine, 2025 -- Autonomous Oxygen Titration for Maintaining Normoxemia in Acutely Ill Adults: The SAVE-O2 AI Randomized Clinical Trial
  2. mdspire news — Can automated oxygen improve titration?
  3. Intensive Care Medicine — Monitoring the Oxygen Reserve Index (ORI) Reduces Hyperoxia Duration in Critically Ill Patients: Findings from the Randomized Controlled ORI2 Trial
  4. Intensive Care Medicine — Comparison of Oxygenation Targets in ICU Settings: A Meta-Analysis of Individual Patient Data
  5. Intensive Care Medicine — Oxygen Administration Strategies in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation: A Comparison of Conservative and Liberal Targets
  6. Can automated oxygen improve titration?
  7. Monitoring the Oxygen Reserve Index (ORI) Reduces Hyperoxia Duration in Critically Ill Patients
  8. Comparison of Oxygenation Targets in ICU Settings: A Meta-Analysis of Individual Patient Data
  9. Surviving Sepsis Campaign Adult Guidelines | SCCM
  10. Conservative Oxygen Therapy in Mechanically Ventilated Critically Ill Adult Patients: The UK-ROX Randomized Clinical Trial | Trials | JAMA | JAMA Network
  11. Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure | New England Journal of Medicine
  12. Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation | New England Journal of Medicine
  13. Liberal or Conservative Oxygen Therapy for Acute Respiratory Distress Syndrome | New England Journal of Medicine
  14. Oxygen Targets in Comatose Survivors of Cardiac Arrest | New England Journal of Medicine
  15. Conservative versus liberal oxygen therapy for mechanically ventilated patients: a systematic review and meta-analysis of randomized controlled trials
  16. Autonomous Oxygen Titration for Maintaining Normoxemia in Acutely Ill Adults: The SAVE-O2 AI Randomized Clinical Trial | Trials | JAMA Internal Medicine | JAMA Network
  17. Automated Oxygen Titration With Noninvasive Respiratory Support in Acute In-Patient Care - Louis W. Kirton, Allie L. Eathorne, Julie K. Cook, Rowan J. Hamill, Stacey M. Kung, Alex C. Semprini, Ruth A.C. Semprini, Mark Weatherall, Richard Beasley, 2025

Original Source(s)

Autonomous Oxygen Titration for Maintaining Normoxemia in Acutely Ill Adults: The SAVE-O 2 AI Randomized

  • by David J. Douin, John D. Rice, Mengli Xiao, Laurel E. Beaty, Claire J. Guo, Cori Withers, Amy Sullivan, Erin L. Anderson, Alex C. Cheng, Mary K. Banasiewicz, Matthew W. Semler, Bradley D. Lloyd, Amelia W. Maiga, Kevin W. Gibbs, Gregory R. Stettler, Akram Khan, Mitchell B. Sally, Franklin L. Wright, Arek J. Wiktor, Neil R. Aggarwal, Vikhyat S. Bebarta, Adit A. Ginde, SAVE-O AI Investigators, Laura G. Murphy, Erika V. Alor, Yvette R. Evans, Laura A. Aguilar-Marquez, Jessica Cwik, Katie Gray, Dagmawit Getachew, April Johnson, Jakea D. Johnson, Karen F. Miller, Tracy L. Morgan, Shannon K. Pugh, Edward T. Qian, Colleen Ratcliff, Sabrina A. Shipman, Adam Turner, Lakeysha C. Wiggins, Genesis Briceno, Aidan Flieger, Nola Iwasaki, Riya Mathew, Chloe K. Ouchida, Jose Pena, Edvinas Pocius, Emily Tribbet, Samantha Underwood, Heather L. Clark, Copeland Graham, Leigha Landreth, Lisa Parks, Darija Ward

  • October 1, 2026

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