{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:12:03Z","timestamp":1753891923128,"version":"3.41.2"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Bubble CPAP (bCPAP) is highly effective in the treatment of respiratory distress syndrome of prematurity and other causes of newborn respiratory insufficiency. To overcome barriers to bCPAP access a novel system was developed that is designed to be cleaned, disinfected, and reused. This study evaluated whether use of reprocessed bCPAP systems increases the rate of sepsis in neonates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A <jats:italic>post hoc<\/jats:italic> analysis of a single-center randomized controlled trial (registration no. NCT06082674) was conducted that compared mechanical ventilator driven CPAP devices (MV-CPAP) with single-use circuits to reusable bCPAP systems that were cleaned and disinfected after each use. The primary outcome was a composite of treatment escalation or death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy-five neonates were randomized to the two CPAP treatment arms. No significant differences in death (5 vs. 4), escalation of care (10 vs. 9), and the composite outcome (OR\u2009=\u20090.84; 95% CI: 0.30\u20132.35, <jats:italic>p<\/jats:italic>\u2009=\u20090.743) were detected in the MV-CPAP and bCPAP groups respectively. There were no clinically significant differences in any of the secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Use of a reprocessed bCPAP system designed to increase global access to CPAP did not increase rates of neonatal sepsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p><jats:uri>ClinicalTrials.gov<\/jats:uri>, identifier, (NCT06082674).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1569437","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T05:14:12Z","timestamp":1747631652000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of a novel reprocessed bCPAP system on sepsis rates among preterm neonates with respiratory distress: a randomized controlled trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Sarah","family":"Badin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Navid","family":"Roodaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisy Evangeline C.","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rochelle","family":"Abila-Cariaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas F.","family":"Burke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"year":"2024","key":"B1","article-title":"Newborn mortality"},{"key":"B2","doi-asserted-by":"publisher","first-page":"6027","DOI":"10.1016\/j.vaccine.2016.03.040","article-title":"Neonatal death: case definition & guidelines for data collection, analysis, and presentation of immunization safety data","volume":"34","author":"Pathirana","year":"2016","journal-title":"Vaccine"},{"key":"B3","doi-asserted-by":"publisher","first-page":"64","DOI":"10.3390\/tropicalmed7050064","article-title":"2.5 million annual deaths-are neonates in low- and middle-income countries too small to be seen? 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