• The technology described in this briefing is FreeO2 automatic oxygen titration. It is designed to use blood oxygen saturation (SpO2) levels to automatically adjust the flow of oxygen to a person, with the goal of achieving and maintaining target SpO2.

  • The innovative aspects are that it offers automatic oxygen titration.

  • The intended place in therapy would be in a hospital setting instead of standard manual oxygen therapy.

  • The main points from the evidence summarised in this briefing are from 6 studies including 4 randomised controlled trials and 2 prospective single-centre crossover trials with a total of 552 people. They show that FreeO2 may increase time spent in target SpO2 range compared with standard manual oxygen therapy and may also reduce onward admissions to intensive care.

  • Key uncertainties are that the evidence base is developing and currently limited to non‑UK based settings. It would further benefit from evidence showing long‑term patient outcomes, evidence across populations of people with acute respiratory distress from COVID‑19, and evidence in babies and children. Further evaluation is also needed to understand differences in the precision of SpO2 monitors across different skin colours.

  • Experts advised that the technology was novel but lacked evidence on efficacy in some patient groups. They added that the device could reduce risk from oxygen toxicity. They also reported some gaps in the evidence base, including the cost benefits of the device and its implementation into the healthcare system.

  • The cost of FreeO2 is £9,600 per unit (excluding VAT). The resource impact would be in addition to standard care. The expected lifespan of FreeO2 is 5 years, with a yearly preventative maintenance and calibration cost of £450.