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Automated Versus Manual Oxygen Titration With the EMILY.AI Device in Hospitalized Patients With Acute Respiratory Failure

9 novembre 2026 mis à jour par: Aether Tech S.L.

Functional, Clinical, and Predictive Validation Study of the EMILY AI Device in Patients With Acute and Chronic Respiratory Failure: Randomized Substudy in a Conventional Hospital Ward

This randomized study evaluates EMILY.AI, an investigational (non-CE-marked) smart oxygen valve that automatically adjusts the oxygen flow delivered to a patient, second by second, according to oxygen saturation (SpO2), heart rate and respiratory rate measured by a pulse oximeter.

Adults admitted to the pulmonology ward of Hospital Universitario Fundación Jiménez Díaz (Madrid, Spain) with acute respiratory failure are randomly assigned to receive oxygen titrated automatically by EMILY.AI or oxygen managed as usual by the nursing team, from randomization until hospital discharge. All participants wear the device; in the usual-care group it only records data.

The study compares the time patients stay within their target saturation range, episodes of low and high oxygen, nursing workload, oxygen use, length of stay and patient experience. This substudy is part of clinical investigation FJD-EMILY-23-02, whose other substudies are registered in separate records.

Aperçu de l'étude

Statut

Pas encore de recrutement

Les conditions

Intervention / Traitement

Description détaillée

Background On conventional hospital wards, oxygen is usually given at a fixed flow and saturation is checked about once per nursing shift, so periods of hypoxaemia or hyperoxaemia can go undetected. EMILY.AI combines a medical-grade oxygen valve with an edge-computing fuzzy-logic algorithm that sets the oxygen flow every second, with continuous logging of physiological signals and delivered flow.

Design Prospective, single-blind (participant), randomized, parallel-group study. Participants are randomized 1:1 to the EMILY arm (automatic titration) or the MANUAL arm (usual care with nursing monitoring every 8 hours and a fixed oxygen prescription), using permuted blocks of 4 stratified by main admission diagnosis (COPD exacerbation, pneumonia, interstitial lung disease, other) and prior long-term home oxygen therapy (yes or no). Allocation takes place after eligibility is confirmed and informed consent is signed.

Intervention and follow-up All participants are connected to the EMILY.AI device continuously from randomization until hospital discharge. In the EMILY arm the device titrates oxygen autonomously to keep SpO2 within the target range for the type of respiratory failure (hypoxaemic 91-97%; hypercapnic 91-94%). In the MANUAL arm the device works in fixed mode, recording SpO2, heart rate and respiratory rate without changing the flow, and nurses adjust oxygen as usual. Conventional back-up oxygen is available at all times.

Sample size 100 participants: 80 planned for the main comparison and approximately 20 added by protocol amendment (CIP v8.0) to further validate an adjustment of the algorithm parameter that sets the minimum oxygen flow in hypoxaemic patients. All 100 are randomized in the same way. As a pilot functional validation, no formal sample size calculation was performed.

The protocol FJD-EMILY-23-02 also includes a substudy in the Respiratory Intermediate Care Unit and an exercise substudy (six-minute walk test), registered separately.

Type d'étude

Interventionnel

Inscription (Estimé)

100

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

  • Nom: Alba Naya Prieto, MD
  • Numéro de téléphone: +34 915 50 48 00
  • E-mail: alba.naya@fjd.es

Sauvegarde des contacts de l'étude

  • Nom: Sarah Beatrice Heili Frades, MD, PhD
  • Numéro de téléphone: +34 915 50 48 00
  • E-mail: SHeili@fjd.es

Lieux d'étude

  • Espagne
      • Madrid, Espagne, 28040
        • Hospital Universitario Fundación Jiménez Díaz
        • Contact:
          • Sarah Beatrice Heili Frades Zimmermann MD, PhD
          • Numéro de téléphone: +34 915 50 48 00
          • E-mail: SHeili@fjd.es
        • Contact:
          • Alba Naya Prieto, MD
          • Numéro de téléphone: +34 915 50 48 00
          • E-mail: alba.naya@fjd.es
        • Chercheur principal:
          • Sarah Beatrice Heili Frades Zimmermann, MD, PhD

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • Men and women aged 18 years or older.
  • Admitted to the general pulmonology ward (Unit 67) of Hospital Universitario Fundación Jiménez Díaz.
  • Acute respiratory failure, defined as baseline arterial PaO2 below 60 mmHg or the need for supplemental oxygen to maintain SpO2 above 90%. Patients on long-term oxygen therapy are eligible if a clinical deterioration requires a higher-than-usual oxygen flow to maintain SpO2 above 90%.
  • Signed informed consent.

Exclusion Criteria:

  • Anatomical abnormalities preventing correct placement of the pulse oximeter.
  • Pregnancy or breastfeeding (women of childbearing potential require a negative pregnancy test at screening).
  • Need for non-invasive ventilation or high-flow nasal cannula at admission.
  • Palliative care or limitation of therapeutic effort at admission.
  • Expected hospital stay under 48 hours.
  • Clinical situations expected to determine length of stay independently of oxygen therapy, such as intravenous antibiotics for more than 10 days, scheduled interventional or surgical procedures, active social care needs that may delay discharge, a non-respiratory main admission diagnosis, or acute or decompensated non-respiratory comorbidities.
  • Known or suspected carbon monoxide poisoning or methemoglobinemia.
  • Severe hypercapnia with decompensated respiratory acidosis (pH below 7.30), hemodynamic instability requiring vasoactive drugs, or severe sepsis at admission.
  • Cognitive impairment, behavioral disorder or any circumstance preventing proper use of the device or compliance with study procedures.
  • Simultaneous participation in another interventional clinical trial, or readmission of a patient previously included in this study.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Seul

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: EMILY

Automatic oxygen titration by EMILY.AI 24 hours a day from randomization to hospital discharge, targeting SpO2 91-97% (hypoxaemic) or 91-94% (hypercapnic).
Dispositif: EMILY.AI closed-loop oxygen titration

Investigational smart oxygen valve with an embedded fuzzy-logic algorithm that adjusts oxygen flow every second from pulse-oximetry SpO2, heart rate and respiratory rate to keep SpO2 within a target range. Other names: EMILY.AI Smart Valve
Comparateur actif: MANUAL

Usual care: fixed oxygen prescription adjusted by nursing staff, with vital signs checked every 8 hours. The EMILY.AI device is connected in fixed mode and only records data.
Autre: Manual oxygen titration

Usual care: oxygen flow set and adjusted by the ward nursing team according to standard practice. The EMILY.AI device stays connected in fixed mode, recording signals but not controlling delivery.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Percentage of time with SpO2 within the target range
Délai: From randomization to hospital discharge, up to 30 days.

Percentage of monitored time with SpO2, measured continuously by the device's pulse oximeter, within the target range for the type of respiratory failure (hypoxaemic 91-97%; hypercapnic 91-94%). Compared between the EMILY and MANUAL arms.
From randomization to hospital discharge, up to 30 days.

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Proportion of participants with SpO2 in range more than 95% of the time
Délai: From randomization to hospital discharge, up to 30 days.

Proportion of participants in each arm whose SpO2 stays within their target range for more than 95% of the monitored time.
From randomization to hospital discharge, up to 30 days.
Time with SpO2 below the target range
Délai: From randomization to hospital discharge, up to 30 days.

Percentage of monitored time with SpO2 below the target range for the type of respiratory failure (hypoxaemia).
From randomization to hospital discharge, up to 30 days.
Time with SpO2 above the target range
Délai: From randomization to hospital discharge, up to 30 days.

Percentage of monitored time with SpO2 above the target range while oxygen is being delivered (hyperoxaemia).
From randomization to hospital discharge, up to 30 days.
Nursing oxygen flow adjustments
Délai: From randomization to hospital discharge, up to 30 days.

Number of oxygen flow changes and oxygen interface changes made by nursing staff per shift (morning, afternoon, night).
From randomization to hospital discharge, up to 30 days.
Number of nursing vital sign measurements per shift
Délai: From randomization to hospital discharge, up to 30 days.

Total number of individual vital sign measurements taken by nursing staff per 8-hour shift, where each recording of SpO2, temperature, blood pressure, heart rate or respiratory rate counts as one measurement. For each participant, the counts are averaged across all shifts of the stay and reported as the mean number of measurements per shift.
From randomization to hospital discharge, up to 30 days.
Calls to the physician
Délai: From randomization to hospital discharge, up to 30 days.

Number of calls to the physician related to desaturation, oxygen flow changes or abnormal vital signs.
From randomization to hospital discharge, up to 30 days.
Total oxygen delivered
Délai: From randomization to hospital discharge, up to 30 days.

Total oxygen delivered (litres) during the hospital stay.
From randomization to hospital discharge, up to 30 days.
Mean oxygen flow
Délai: From randomization to hospital discharge, up to 30 days.

Mean oxygen flow (litres per minute) delivered during the hospital stay.
From randomization to hospital discharge, up to 30 days.
Length of hospital stay
Délai: From randomization to hospital discharge, up to 30 days.

Days from randomization to hospital discharge.
From randomization to hospital discharge, up to 30 days.
Escalation to a higher level of respiratory support
Délai: From randomization to hospital discharge, up to 30 days.

Proportion of participants requiring high-flow nasal cannula, non-invasive ventilation, or transfer to the Respiratory Intermediate Care Unit or ICU due to respiratory or hemodynamic deterioration.
From randomization to hospital discharge, up to 30 days.
Device alerts
Délai: From randomization to hospital discharge, up to 30 days.

Number of alerts generated by EMILY.AI related to oxygenation or vital signs per participant during the hospital stay.
From randomization to hospital discharge, up to 30 days.
Percentage of device alerts corresponding to a true clinical change
Délai: From randomization to hospital discharge, up to 30 days.

Percentage of EMILY.AI alerts confirmed by the clinical team as corresponding to a true clinical change.
From randomization to hospital discharge, up to 30 days.
Change in arterial partial pressure of oxygen (PaO2)
Délai: At randomization and at hospital discharge (up to 30 days).

Change in PaO2 (mmHg) measured by arterial blood gas analysis between randomization and hospital discharge.
At randomization and at hospital discharge (up to 30 days).
Change in arterial partial pressure of carbon dioxide (PaCO2)
Délai: At randomization and at hospital discharge (up to 30 days).

Change in PaCO2 (mmHg) measured by arterial blood gas analysis between randomization and hospital discharge.
At randomization and at hospital discharge (up to 30 days).
Change in arterial pH
Délai: At randomization and at hospital discharge (up to 30 days).

Change in arterial pH (pH units) measured by arterial blood gas analysis between randomization and hospital discharge.
At randomization and at hospital discharge (up to 30 days).
Change in dyspnoea measured with the modified Borg Dyspnoea Scale
Délai: At randomization and at hospital discharge (up to 30 days).

Change between randomization and hospital discharge in dyspnoea measured with the modified Borg Dyspnoea Scale, which ranges from 0 (no breathlessness at all) to 10 (maximal breathlessness). Higher scores mean a worse outcome.
At randomization and at hospital discharge (up to 30 days).
Satisfaction with oxygen therapy measured with a 5-point Likert scale
Délai: At hospital discharge (up to 30 days).

Participant-reported satisfaction with oxygen therapy at hospital discharge, measured with a single-item 5-point Likert scale ranging from 1 (very dissatisfied) to 5 (very satisfied). Higher scores mean a better outcome.
At hospital discharge (up to 30 days).

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
Intercurrent events
Délai: From randomization to hospital discharge, up to 30 days.

Number of participants with falls with clinical consequences, non-respiratory nosocomial infection, acute cardiovascular events, major bleeding, decompensation of non-respiratory comorbidity, social problems prolonging stay, or unplanned procedures.
From randomization to hospital discharge, up to 30 days.

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Aether Tech S.L.

Collaborateurs

Hospital Universitario Fundación Jiménez Díaz

Les enquêteurs

  • Chercheur principal: Sarah Beatrice Heili Frades, MD, PhD, MD, PhD, Hospital Universitario Fundación Jiménez Díaz

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

1 février 2027

Achèvement primaire (Estimé)

1 décembre 2027

Achèvement de l'étude (Estimé)

1 décembre 2027

Dates d'inscription aux études

Première soumission

28 octobre 2026

Première soumission répondant aux critères de contrôle qualité

9 novembre 2026

Première publication (Réel)

12 novembre 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

12 novembre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

9 novembre 2026

Dernière vérification

1 novembre 2026

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • FJD-EMILY-23-02-WARD
  • FJD-EMILY-23-02 (Autre identifiant: Aether Tech S.L.)

Plan pour les données individuelles des participants (IPD)

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INDÉCIS

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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