• Louis W Kirton, Raulle Sol Cruz, Leanlove Navarra, Allie Eathorne, Julie Cook, Richard Beasley, and Paul J Young.
• Medical Research Institute of New Zealand, Wellington, New Zealand.
• Crit Care Resusc. 2024 Jun 1; 26 (2): 647064-70.

ObjectiveThe objective of this study was to determine whether automated titration of the fraction of inspired oxygen (FiO2) increases the time spent with oxygen saturation (SpO2) within a predetermined target SpO2 range compared with manually adjusted high-flow oxygen therapy in postoperative cardiac surgical patients managed in the intensive care unit (ICU).DesignSingle-centre, open-label, randomised clinical trial.SettingTertiary centre ICU.ParticipantsRecently extubated adults following elective cardiac surgery who required supplemental oxygen.InterventionsAutomatically adjusted FiO2 (using an automated oxygen control system) compared with manual FiO2 titration, until cessation of oxygen therapy, ICU discharge, or 24 h (whichever was sooner).Main Outcome MeasuresThe primary outcome was the proportion of time receiving oxygen therapy with the SpO2 in a SpO2 target range of 92-96 %.ResultsAmong 65 participants, the percentage of time per patient spent in the target SpO2 range was a median of 97.7 % (interquartile range: 87.9-99.2 %) and 91.3 % (interquartile range: 77.1-96.1 %) in the automated (n = 28) and manual (n = 28) titration groups, respectively. The estimated effect of automated FiO2, compared to manual FiO2 titration, was to increase the percentage of time spent in the target range by a median of 4.8 percentage points (95 % confidence interval: 1.6 to 10.3 percentage points, p = 0.01).ConclusionIn patients recently extubated after cardiac surgery, automated FiO2 titration significantly increased time spent in a target SpO2 range of 92-96 % compared to manual FiO2 titration.© 2024 The Authors.

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