SAVE-O2
Trial question
What is the effect of targeted normoxemia in critically ill trauma patients?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
30.0% female
70.0% male
N = 12487
12487 patients (3688 female, 8799 male).
Inclusion criteria: adult trauma patients admitted to an ICU.
Key exclusion criteria: age < 18 years; pregnancy; incarceration; transfer from another hospital.
Interventions
N=5661 targeted normoxemia (encouragement to decrease supplemental oxygen for SpO2 > 96%).
N=6826 usual care (supplemental oxygen administration determined by treating clinicians).
Primary outcome
Supplemental oxygen-free days through day 28
19.6 days
17.5 days
19.6 days
14.7 days
9.8 days
4.9 days
0.0 days
Targeted
normoxemia
Usual
care
No significant
difference ↔
No significant difference in supplemental oxygen-free days through day 28 (19.6 days vs. 17.5 days; MD 0.32, 95% CI -0.37 to 1).
Secondary outcomes
No significant difference in hospital death at day 90 (9.9% vs. 10.7%; HR 1.05, 95% CI 0.83 to 1.33).
No significant difference in hospital-free days through day 90 (69.8 days vs. 69 days; MD 1.16, 95% CI -0.35 to 2.68).
Significant decrease in time for weaning to room air (1.6 days vs. 2.7 days; HR 0.81, 95% CI 0.75 to 0.85).
Conclusion
In adult trauma patients admitted to an ICU, targeted normoxemia was not superior to usual care with respect to supplemental oxygen-free days through day 28.
Reference
David J Douin, John D Rice, Erin L Anderson et al. Targeted Normoxemia and Supplemental Oxygen-Free Days in Critically Injured Adults: A Stepped-Wedge Cluster Randomized Clinical Trial. JAMA Netw Open. 2025 Mar 3;8(3):e252093.
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