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Aim: To examine the impact of introducing and implementing the Vayu bubble continuous positive airway pressure (bCPAP) system on neonatal survival and neonatal respiratory outcomes in a neonatal intensive care unit (NICU) in the Philippines., Methods: We compared clinical outcomes of 1,024 neonates before to 979 neonates after introduction of Vayu bCPAP systems into a NICU. The primary outcome was survival to discharge. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated. Analyses were undertaken separately for the entire NICU population and for neonates who received any form of respiratory support., Results: The introduction of the Vayu bCPAP system was associated with (1) significant reductions in intubation (aOR: 0.75; 95% CI: 0.58-0.96) and in the use of nasal intermittent positive-pressure ventilation (NIPPV) (aOR: 0.69; 95% CI: 0.50-0.96) among the entire NICU population and (2) a significant increase in survival to discharge (aOR: 1.53; 95% CI: 1.09-2.17) and significant reductions in intubation (aOR: 0.52; 95% CI: 0.38-0.71), surfactant administration (aOR: 0.60; 95% CI: 0.40-0.89), NIPPV use (aOR: 0.52; 95% CI: 0.36-0.76), and a composite neonatal adverse outcome (aOR: 0.60; 95% CI: 0.42-0.84) among neonates who received any form of respiratory support., Conclusion: The use of the Vayu bCPAP system in a NICU in the Philippines resulted in significant improvement in neonatal respiratory outcomes., Competing Interests: TB is the Founder of Vayu Global Health Innovations, a public benefit company that has signed with and is accountable to the Bill and Melinda Gates Foundation, UNITAID, and World Health Organization in its commitment to global good and global access in the development of high quality ultra-low-cost bubble continuous positive airflow pressure and oxygen blender systems. Vayu Global Health Innovations played no role in the manuscript's conception, writing, or the decision to submit for publication. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Rauschendorf, Bou Saba, Meara, Roodaki, Conde-Agudelo, Garcia and Burke.)

Background: Safe and effective oxygen delivery methods are not available for the majority of infants and young children globally. A novel oxygen blender system was designed to accurately deliver concentration-controlled, oxygen-enriched air to hypoxemic children up to age five. The system does not require compressed medical air, is compatible with both oxygen tanks and oxygen concentrators, and is low cost. This is the first study that tested the performance of the innovative oxygen blender system., Methods: The performance of the oxygen blender system was assessed in vitro based on delivered oxygen levels and flow rates with an oxygen tank, an oxygen tank using a nasal occlusion model, and an oxygen concentrator., Results: The measured %O 2 of the performance test was within ± 5% of full scale (FS) of the target value across all flows and all nasal cannulas. Occlusion testing demonstrated that 50% occlusion did not significantly affect the system outputs. The oxygen blender system was shown to be compatible with both oxygen tanks and oxygen concentrators., Conclusions: The novel oxygen blender system accurately controls oxygen concentrations and blended air flow rates, and is compatible with both oxygen tanks and oxygen concentrators. This innovation may be an opportunity for improved infant and child oxygen treatment worldwide., Competing Interests: Authors MD and EN are engineers with Vayu Global Health Innovations, a public benefit company that develops high quality ultra—low cost oxygen delivery solutions. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ng, Dundek and Burke.)