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Matthew Semler (Nashville, USA) presents the PILOT trial at the Critical care Reviews Meeting 2023, in Titanic Belfast. The PILOT trial compared low, intermediate and high oxygenation targets in critically ill mechanically ventilated patients. Kath Maitland from Kigali, Kenya, delivers an independent editorial. The session is chaired by Chris Seymour from Pittsburgh, USA. PILOT was published in the New England Journal of Medicine on November 10th, 2022.