Automated Oxygen Titration With the EMILY.AI Device in a Respiratory Intermediate Care Unit

Inclusion Criteria: * Men and women over 18 years of age or older. * Admitted to the Respiratory Intermediate Care Unit with 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%. * Spontaneous breathing without positive-pressure ventilatory support (invasive or non-invasive mechanical ventilation, or CPAP) for at least 8 consecutive hours. * Able to understand the study and sign informed consent. Exclusion Criteria: * Hemodynamic instability or need for vasoactive drugs. * Severe temperature changes (axillary temperature above 39 °C or below 35 °C). * Hemoglobinopathies or severe anemia (hemoglobin below 7 g/dL). * Severe acidosis (pH below 7.20) or severe alkalosis (pH above 7.55). * Anatomical abnormalities preventing correct placement of the pulse oximeter. * Pregnancy or breastfeeding (women of childbearing potential require a negative pregnancy test at screening). * Oxygen flow requirement exceeding the valve capacity (more than 40 L/min).