Evidence map›Paper›PMID 36278971›Full record

Trial reportThe New England journal of medicine2022

Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation.

Matthew W Semler, Jonathan D Casey, Bradley D Lloyd, Pamela G Hastings, Margaret A Hays, Joanna L Stollings, Kevin G Buell, John H Brems, Edward T Qian, Kevin P Seitz and 9 more

3 registry-linked trialsOpen access · greenAbstract readPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in The New England journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 94 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
94citing papers in PubMed, 9 pooled it
28.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06501118 narecruitingnot on this mapstarted 2024, after this paper: background citation

Optimizing Care in Critically Ill at UCHealth by Liberalizing the Target O2 in Mechanically-ventilated ICU Patients

TypeinterventionalSponsorUniversity of Colorado, DenverRan2024 to 2026Enrolled3,600ConditionsRespiratory Failure, Acute Hypoxemic Respiratory Failure, Acute Hypoxic Respiratory Failure, HypoxemiaArmsEducation, Epic notification alert
NCT07258823 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Study on the Effectiveness of Continuous Compression-synchronous Ventilation (Bio-CPR) in the ACLS Stage of Cardiopulmonary Resuscitation (ACLS) Based on the Bionic Concept to Explore the Best Mechanical Ventilation Strategy

TypeinterventionalSponsorGuangdong Provincial People's HospitalRan2026 to 2027Enrolled408ConditionsOut-of-hospital Cardiac Arrest (OHCA), Cardiac Arrest (CA), CPR, ACLSArmsCPR
NCT07536984 naenrolling by invitationnot on this mapstarted 2026, after this paper: background citation

Examination of Personalized SpO2 Targets

TypeinterventionalSponsorVanderbilt University Medical CenterRan2026 to 2030Enrolled3,000ConditionsAcute Respiratory FailureArmsPersonalized SpO2 Target, Usual Care
3 · Its place in the literature

Who cites it

94 citing papers in PubMed, 9 syntheses or guidelines pooled it, 199 citations in OpenAlex.

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  4. [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025
    Guideline
  5. Conservative versus liberal oxygen therapy in mechanically ventilated patients: A systematic review with meta-analysis.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2025
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  20. Effects of intraoperative inspired oxygen fraction (FiOCritical care (London, England) · 2023
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34 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 6 institutions in 3 countries.

Matthew W SemlerFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Jonathan D CaseyFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.ORCID 0000-0001-7188-4200
Bradley D LloydFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Pamela G HastingsFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Margaret A HaysFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Joanna L StollingsFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Kevin G BuellFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
John H BremsFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Edward T QianFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Kevin P SeitzFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Li WangFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Christopher J LindsellFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Robert E FreundlichFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Jonathan P WandererFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Jin H HanFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Gordon R BernardFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
Wesley H SelfFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.ORCID 0000-0002-9300-3045
Todd W RiceFrom the Divisions of Allergy, Pulmonary, and Critical Care Medicine (M.W.S., J.D.C., M.A.H., E.T.Q., K.P.S., G.R.B., T.W.R.) and Respiratory Care (B.D.L., P.G.H.), the Departments of Pharmaceutical Services (J.L.S.), Medicine (K.G.B., J.H.B.), Biostatistics (L.W., C.J.L.), Anesthesiology (R.E.F., J.P.W.), Biomedical Informatics (R.E.F., J.P.W.), and Emergency Medicine (J.H.H., W.H.S.), and the Vanderbilt Institute for Clinical and Translational Research (G.R.B., W.H.S., T.W.R.), Vanderbilt University Medical Center, and the Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System (J.H.H.) - all in Nashville.
PILOT Investigators and the Pragmatic Critical Care Research Group
Pulmonary and Allergy Associates · USL-3 Communications (United States) · USBiomedical Informatics Research Center Antwerp · BECancer Research And Biostatistics · USRespiratory Clinical Trials · AUVA Tennessee Valley Healthcare System · US

Funding

Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7M
The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Institutional Career Development CoreKL2TR002245 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Julie A. Bastarache · 2017 to 2026
$9.3M
Clinical and Translational Training Program in Pulmonary MedicineT32HL087738 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Lorraine B Ware · 2007 to 2026
$7.0M
Bag-Mask Ventilation to PreVent Hypoxemia during Tracheal Intubation in the Emergency Department: A Clinical TrialK23HL153584 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI CASEY, JONATHAN DALE · 2020 to 2024
$900k
Reducing Reintubation Risk in High-Risk Cardiac Surgery Patients with High-Flow Nasal Cannula -the "I-CAN" studyK23HL148640 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI FREUNDLICH, ROBERT EDWARD · 2020 to 2024
$867k
Oxygen Saturation Targets during Mechanical Ventilation of Critically Ill Adults: A Clinical TrialK23HL143053 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI SEMLER, MATTHEW WALL · 2018 to 2022
$854k
NCATS NIH HHS KL2 TR002245NCATS NIH HHS UL1 TR000445NCATS NIH HHS UL1 TR002243NCATS NIH HHS UL1TR002243NHLBI NIH HHS K23 HL143053NHLBI NIH HHS K23HL143053NHLBI NIH HHS K23 HL148640NHLBI NIH HHS K23 HL153584NHLBI NIH HHS L30 HL143597NHLBI NIH HHS T32 HL087738
6 · The paper itself

Abstract

backgroundInvasive mechanical ventilation in critically ill adults involves adjusting the fraction of inspired oxygen to maintain arterial oxygen saturation. The oxygen-saturation target that will optimize clinical outcomes in this patient population remains unknown.

methodsIn a pragmatic, cluster-randomized, cluster-crossover trial conducted in the emergency department and medical intensive care unit at an academic center, we assigned adults who were receiving mechanical ventilation to a lower target for oxygen saturation as measured by pulse oximetry (Spo

resultsA total of 2541 patients were included in the primary analysis. The median number of ventilator-free days was 20 (interquartile range, 0 to 25) in the lower-target group, 21 (interquartile range, 0 to 25) in the intermediate-target group, and 21 (interquartile range, 0 to 26) in the higher-target group (P = 0.81). In-hospital death by day 28 occurred in 281 of the 808 patients (34.8%) in the lower-target group, 292 of the 859 patients (34.0%) in the intermediate-target group, and 290 of the 874 patients (33.2%) in the higher-target group. The incidences of cardiac arrest, arrhythmia, myocardial infarction, stroke, and pneumothorax were similar in the three groups.

conclusionsAmong critically ill adults receiving invasive mechanical ventilation, the number of ventilator-free days did not differ among groups in which a lower, intermediate, or higher Spo

Indexed as

Critical IllnessOxygenRespiration, ArtificialAcademic Medical CentersAdultCritical CareCross-Over StudiesEmergency Service, HospitalHospital MortalityHumansIntensive Care UnitsOximetryOxygen

Identifiers

PMID36278971
PMCPMC9724830
OpenAlexW4307179271

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.