---
title: An Automated Device Held Hospital Patients in Their Oxygen Range 85 Percent of the Time
description: A randomized trial of 300 hospital patients found automated oxygen titration held them in the target range 85 percent of the time, against 63 percent by hand.
author: Darie Nani (Editor-in-Chief)
updated: 2026-08-04T15:19:09.521Z
canonical: https://www.sovereignmagazine.com/article/automated-oxygen-titration-trial-time-in-range
image: https://cdn.nanimediahouse.com/pulse-oximeter-automated-oxygen-trial-99859.webp
categories: Science & Tech
content_type: News
region: United States
publication: Sovereign Magazine
schema_type: Article
---

Hospitalized patients whose supplemental oxygen was managed by an automated device spent 85 percent of their first 72 hours inside the target oxygen range. Patients whose oxygen was set by hand, the way it is set in almost every hospital, spent 63 percent. The finding comes from a randomized trial of 300 adults led by the University of Colorado Anschutz, published in JAMA Internal Medicine on August 3 and presented the same day at the Military Health System Research Symposium.

Oxygen is one of the most widely used treatments in medicine and one of the last still delivered by hand. A nurse or a respiratory therapist reads a monitor during a periodic check, turns the flow up or down, and moves on. Between those checks a patient can drift out of range in either direction.

> "Oxygen is one of the most widely used therapies in medicine yet even in 2026, it is still managed largely through repeated manual adjustments made by clinicians."
> — Adit Ginde, MD, MPH, senior associate dean for clinical research, CU Anschutz School of Medicine

The trial tested a device called the O2matic PRO100 against that routine. It takes its readings from a pulse oximeter, the small sensor clipped to a fingertip that estimates blood oxygen using light, and adjusts the oxygen flow continuously, through the night as well as the day, without waiting for a clinician. Patients on the device received oxygen through a nasal cannula at up to 6 liters a minute, or a face mask at up to 15. The target was [a blood oxygen saturation of 90 to 96 percent, centered on 93](https://clinicaltrials.gov/study/NCT06374225).

## Patients Joined Within 36 Hours of Arriving at Four Trauma Centers

The 300 participants were adults admitted with acute respiratory illness, traumatic injury, burns or surgical recovery, all newly on supplemental oxygen, and all randomly assigned within 36 hours of reaching hospital. The sites were UCHealth University of Colorado Hospital, Vanderbilt University Medical Center, Oregon Health & Science University and Wake Forest University School of Medicine, [all four of them level 1 trauma centers](https://bmjopen.bmj.com/content/16/1/e110739). Enrollment ran from May 2024 to January 2026.

## The Automated Group Spent Less Time Both Above and Below the Range

Time in range was the trial's primary measure, and the gap ran in both directions. Patients on the device spent less time with low blood oxygen and less time with high blood oxygen than the standard-care group, and staff made fewer manual adjustments. The trial recorded no increase in serious adverse events.

“Our findings show that autonomous oxygen titration can help patients remain in their target range more consistently while reducing both under and over oxygenation,” said Ginde, the trial's principal investigator. “This technology has the potential to fundamentally change how supplemental oxygen is delivered in both civilian and military medicine.”

David Douin, an associate professor of anesthesiology at CU Anschutz and the study's first author, said the case for automating the task is how fast the readings move. “Oxygen levels can change quickly in hospitalized patients,” Douin said. “This system responds in real time, helping patients spend more time in their target oxygen range with less manual adjustment.”

## Too Much Oxygen Is Its Own Problem

Low oxygen is the risk clinicians are trained to watch, and it is the reason supplemental oxygen is given at all. Too little can harm organs and too much may also be harmful, the researchers say, which is why the trial counted time above the range as well as below it. The pre-registered analysis plan states the practical problem plainly: the amount of oxygen given frequently exceeds what a patient needs, wasting the supply and leaving the patient above target. Douin and Ginde have shown in earlier work that aiming for moderate oxygen levels is safe in critically ill and injured patients.

## The Defense Health Agency Paid for the Trial With Battlefield Care in Mind

Registered as SAVE-O2 AI, the study was sponsored by the Defense Health Agency's Combat Casualty Care Portfolio through the Medical Technology Enterprise Consortium. Vik Bebarta, chair of emergency medicine at CU Anschutz and a US Air Force Reserve colonel, said the appeal for military medicine is the attention the device gives back.

“When you are caring for a wounded service member hours from a hospital, oxygen runs short and so does the medic's attention,” Bebarta said. “A device that adjusts oxygen on its own takes one urgent task off their hands so they can focus on everything else the patient needs.”

The researchers say automated oxygen titration may also cut workload for hospital nurses and respiratory therapists. That effect was not measured in this trial and is set for future study. The team's next step is to test the technology in emergency transport and prehospital care.

## FAQ

**Q: What is closed-loop oxygen delivery?**
It is a system that continuously reads a patient's blood oxygen level, usually from a pulse oximeter, and adjusts the oxygen flow automatically to hold the patient inside a set target range, instead of a clinician setting the flow by hand during periodic checks.

**Q: What is the purpose of oxygen titration?**
Titration means adjusting how much supplemental oxygen a patient receives so their blood oxygen stays within a target range, high enough to avoid low oxygen levels and no higher than the patient needs. In this trial that range was a saturation of 90 to 96 percent.

**Q: What happens if a patient is given too much oxygen?**
Their blood oxygen rises above the target range, a state called hyperoxemia, and the extra oxygen is used up without benefit. The researchers say too little oxygen can harm organs and too much may also be harmful, so the trial measured time spent on both sides of the range.