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

2026年11月9日 更新者：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.

研究概览

地位

尚未招聘

条件

干预/治疗

详细说明

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.

研究类型

介入性

注册 (估计的)

100

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

  • 姓名：Alba Naya Prieto, MD
  • 电话号码：+34 915 50 48 00
  • 邮箱：alba.naya@fjd.es

研究联系人备份

  • 姓名：Sarah Beatrice Heili Frades, MD, PhD
  • 电话号码：+34 915 50 48 00
  • 邮箱：SHeili@fjd.es

学习地点

  • 西班牙
      • Madrid、西班牙、28040
        • Hospital Universitario Fundación Jiménez Díaz
        • 接触：
          • Sarah Beatrice Heili Frades Zimmermann MD, PhD
          • 电话号码：+34 915 50 48 00
          • 邮箱：SHeili@fjd.es
        • 接触：
          • Alba Naya Prieto, MD
          • 电话号码：+34 915 50 48 00
          • 邮箱：alba.naya@fjd.es
        • 首席研究员：
          • Sarah Beatrice Heili Frades Zimmermann, MD, PhD

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

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.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：单身的

武器和干预

参与者组/臂
干预/治疗
实验性的：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).
设备：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
有源比较器：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.
其他：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.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Percentage of time with SpO2 within the target range
大体时间：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.

次要结果测量

结果测量
措施说明
大体时间
Proportion of participants with SpO2 in range more than 95% of the time
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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)
大体时间：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)
大体时间：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
大体时间：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
大体时间：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
大体时间：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).

其他结果措施

结果测量
措施说明
大体时间
Intercurrent events
大体时间：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.

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Aether Tech S.L.

合作者

Hospital Universitario Fundación Jiménez Díaz

调查人员

  • 首席研究员：Sarah Beatrice Heili Frades, MD, PhD, MD, PhD、Hospital Universitario Fundación Jiménez Díaz

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2027年2月1日

初级完成 (估计的)

2027年12月1日

研究完成 (估计的)

2027年12月1日

研究注册日期

首次提交

2026年10月28日

首先提交符合 QC 标准的

2026年11月9日

首次发布 (实际的)

2026年11月12日

研究记录更新

最后更新发布 (实际的)

2026年11月12日

上次提交的符合 QC 标准的更新

2026年11月9日

最后验证

2026年11月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • FJD-EMILY-23-02-WARD
  • FJD-EMILY-23-02 (其他标识符：Aether Tech S.L.)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

未定

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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