# Oxygen Saturation Targets during Mechanical Ventilation of Critically Ill Adults: A Clinical Trial

> **NIH NIH K23** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2022 · $133,916

## Abstract

PROJECT SUMMARY
Candidate: Dr. Matthew Semler, MD, MSCI is an Assistant Professor at Vanderbilt University Medical Center.
Dr. Semler has a strong background in critical care clinical trials gained through both his formal training in
clinical research and his work conducting prior comparative effectiveness trials in fluid management and
respiratory support. His long-term career plan is to become a physician scientist recognized as the national
leader in the integration of pragmatic comparative effectiveness trials into the delivery of critical care. To
achieve this, his immediate goals are to learn the clinical informatics methods needed to embed clinical trials
within the electronic health record, advance his methodologic expertise in novel trial designs, and master the
advanced modeling techniques required to predict the effect of therapy for individual patients.
Research Project: Each year 2-3 million critically ill adults receive invasive mechanical ventilation, with an
associated in-hospital mortality of 25-35%. Mechanical ventilation of critically ill adults universally involves
titration of the fraction of inspired oxygen (FiO2) to maintain arterial oxygen saturation (SpO2), and yet the
optimal SpO2 target remains unknown. Both hyperoxia and hypoxia may influence organ function, and
improved understanding of the effects of SpO2 target during mechanical ventilation on clinical outcomes of
critical illness is urgently needed. The Specific Aims of the proposed research are: Aim 1) Conduct the
Pragmatic Investigation of optimaL Oxygen Targets (PILOT) trial, a 2,250-patient cluster-crossover trial testing
the hypothesis that use of a lower SpO2 target (90%) for mechanically ventilated ICU patients will result in more
days alive and free of invasive mechanical ventilation than use of an intermediate SpO2 target (94%) or a
higher SpO2 target (98%); and Aim 2) Develop a statistical model predicting the effect of SpO2 target on clinical
outcomes for individual patients, using data from the PILOT trial.
Career Development: Dr. Semler’s career development plan integrates formal coursework with personalized
training with his mentors and collaborators to: 1) strengthen his methodologic foundation in the conduct of
pragmatic comparative effectiveness trials; 2) develop expertise in novel clinical trial designs; 3) master
advanced statistical modeling techniques for cluster-level data and predicting the effect of therapy for individual
patients within a trial, and 4) bolstering his skills as a leader of multi-disciplinary research teams.
Environment: VUMC is the ideal environment to foster Dr. Semler’s development into a national leader in
pragmatic comparative effectiveness trials within critical care. The environment includes an unparalleled team
of NIH-funded mentors and collaborators, an internationally-recognized bioinformatics infrastructure, and the
new Learning Healthcare System component of Vanderbilt’s Clinical and Translational Science Award (...

## Key facts

- **NIH application ID:** 10447779
- **Project number:** 5K23HL143053-05
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Matthew Wall Semler
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $133,916
- **Award type:** 5
- **Project period:** 2018-07-05 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10447779

## Citation

> US National Institutes of Health, RePORTER application 10447779, Oxygen Saturation Targets during Mechanical Ventilation of Critically Ill Adults: A Clinical Trial (5K23HL143053-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10447779. Licensed CC0.

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