RCT

UK-ROX

Conservative Oxygen Therapy in Mechanically Ventilated Critically Ill Adult Patients

JAMA, 2025 · Pragmatic multicenter randomized clinical trial (n=16,500)

Clinical question

Does targeting SpO2 90% (88–92%) reduce 90-day mortality compared with usual oxygen therapy?

Population: Mechanically ventilated critically ill adults receiving supplemental oxygen
Intervention: Conservative oxygen targeting SpO2 90% (range 88–92%)
Comparator: Usual oxygen therapy
Primary outcome: 90-day all-cause mortality
Result: 90-day mortality was 35.4% with conservative oxygen and 34.9% with usual oxygen; no statistically significant difference.

What the trial found

A routine SpO2 target around 90% did not improve survival in unselected mechanically ventilated adults.

Current guideline position

Oxygen targets remain phenotype-specific, with lower targets appropriate for patients at risk of hypercapnic respiratory failure.

Clinical interpretation

Avoid both hypoxemia and unnecessary hyperoxemia; UK-ROX does not support universally lowering oxygen targets to 88–92% in all ventilated ICU adults.

Clinical Context & Relevant Topics (2)

Disease Reference

Invasive Mechanical Ventilation

Complete clinical topic overview. For the full 10-level interactive course, visit Master MV. Covers core ventilator modes, respiratory mechanics (Cstat, Raw, driving pressure), waveform dyssynchrony analysis, VILI prevention, and liberation protocols.

View Topic Context →

Respiratory Failure: Basic Principles

Core taxonomy (Types I–IV), alveolar gas exchange physiology, work-of-breathing mechanics, and escalation thresholds in acute respiratory failure.

View Topic Context →