Automated control of inspired oxygen in mechanically ventilated trauma and acute care surgery patients: A…

Randomized trialThe journal of trauma and acute care surgery· May 2026

Automated control of inspired oxygen in mechanically ventilated trauma and acute care surgery patients: A randomized controlled trial.

Richard D Branson, Thomas C Blakeman, Laura Moore … Michael Goodman

Trauma & Acute Care SurgeryRandomized trialQ1IF 3.4

Automated oxygen control cut hypoxemia episodes versus manual titration in ventilated trauma patients

Automated control of inspired oxygen in mechanically ventilated trauma and acute care surgery patients: A randomized controlled trial.

Richard D Branson … Michael Goodman

The journal of trauma and acute care surgery · May 2026 · Q1 in Surgery

Background

Automated physiologic closed-loop control (physiologic closed-loop control) of inspired oxygen fraction (FIO2) may improve oxygen titration while reducing clinician workload.

Methods

In this randomized, controlled, multicenter trial, adult mechanically ventilated patients were randomized to physiologic closed-loop control or manual control FIO2 titration targeting arterial oxygen saturation (SpO2) of 94%±2%.

Results

hypoxemia was less common with automated oxygen control than manual titration

MC

38%

PCLC

22%

More results

The median time within the SpO2 target range was 36.8% (IQR, 22.1-49.6) with manual control and 30.1% (IQR, 18.4-44.7) with physiologic closed-loop control, meeting criteria for noninferiority [the mean±SD of the relative duration on the transformed scale was 0.53 (0.37) and 0.61 (0.36).

More results

The mean difference between the transformed data was -0.08 with a one-sided lower 97.5% CL of -0.18.

Comparing this lower 95% CL with the prespecified noninferiority margin (noninferiority margin) of -0.35, this difference lay within the noninferiority margin.

“

Conclusion · 1 of 3

In mechanically ventilated trauma and acute care surgery patients, physiologic closed-loop control of FIO2 was noninferior to protocolized manual control for maintaining target oxygen saturation.

Conclusion · 2 of 3

physiologic closed-loop control was associated with fewer hypoxemic events, reduced oxygen usage, and more frequent automated FIO2 changes. (J Trauma Acute Care Surg. 2026;000:000-000. Copyright © 2026 The Author(s).

Conclusion · 3 of 3

Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Surgery of Trauma.). LEVEL OF EVIDENCE: Randomized Controlled Trial with single blinding; Level II.

Automated control of inspired oxygen in mechanically ventilated trauma and acute care surgery patients: A randomized controlled trial.

Automated control of inspired oxygen in mechanically ventilated trauma and acute care surgery patients: A randomized controlled trial.

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