Electronic Alerts for Oxygen Levels During Mechanical Ventilation

(TOOLs Trial)

This trial aims to improve oxygen level management for patients on mechanical ventilation in intensive care. By using electronic alerts, the researchers aim to maintain optimal oxygen levels, avoiding both insufficient and excessive oxygen, which can be harmful. The trial will compare two methods: using electronic alerts for oxygen adjustment and following standard guidelines with one-time doctor orders. It targets individuals who are critically ill and require ventilation for more than a day.

As an unphased trial, it provides a unique opportunity to contribute to important research that could enhance patient care in critical settings.

The trial information does not specify whether you need to stop taking your current medications.

Research has shown that using electronic alerts to manage oxygen levels during mechanical ventilation is generally safe. Studies have found that these alerts can adjust oxygen levels without causing harm. While specific data on negative effects from these studies is lacking, using electronic health records for oxygen adjustments appears well-tolerated. This suggests the process is unlikely to cause significant side effects in patients. Maintaining balanced oxygen levels is crucial, as both too little and too much oxygen can be harmful. This method aims to help maintain that balance safely.¹²³⁴⁵

Researchers are excited about this trial because it explores a novel method for managing oxygen levels during mechanical ventilation using electronic alerts. Unlike the standard practice where oxygen titration is done based on one-time physician orders, this method employs real-time alerts and a decision support tool for respiratory therapists, potentially allowing for more precise and timely adjustments. This approach could lead to improved patient outcomes by ensuring oxygen levels are kept within optimal ranges more consistently.

Research has shown that electronic alerts can effectively manage oxygen levels in patients on breathing machines. In this trial, participants in the intervention arm will receive oxygen titration based on these alerts, which have been proven to reduce both low oxygen levels (hypoxia) and high oxygen levels (hyperoxia). One study found that patients using this system had their oxygen therapy adjusted earlier, with 14.1% being taken off oxygen sooner compared to just 4.3% without it. This suggests that electronic alerts can manage oxygen more accurately, leading to better patient outcomes.¹²³⁴⁶