Nasal and Bronchial Absorption Sampling in RSV Bronchiolitis

NCT ID: NCT03062917

Last Updated: 2019-11-12

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

152 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-10-02

Study Completion Date

2018-06-30

Brief Summary

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This study will compare the novel methods of NS and BS with the standard technique of nasophayngeal aspiration (NPA) and routine ETT suction. We shall assess the samples for diagnosis of RSV, viral load and immune responses in the airways of babies with RSV infection. We shall also assess the genetics of babies included in this study, to see if they may be vulnerable to RSV infection.

Detailed Description

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In conjunction with a specialist medical device manufacturing company (Hunt Developments (Midhurst, West Sussex) we have produced novel nasosorption and bronchosorption kits that have CE marking. Both nasosorption and bronchosorption methods use synthetic absorptive matrix (SAM) strips: that look and feel like blotting paper, and will be placed onto the mucosal surface. These are comfortable to use and can be used at frequent intervals over extended periods of time. This non-invasive technique is ideal for infants and children, and it is possible to obtain neat mucosal lining fluid (MLF) even from normal healthy noses. The eluates contain cytokines and chemokines at high detectable levels on multiplex immunoassay.

We would like to use these SAMs to take MLF samples from the nasal and bronchial mucosal surfaces to see if these novel techniques can overcome the problems with current sampling methods. We plan to use these absorption techniques to measure RSV viral load. We also aim to look at the immune response in terms of the anti-viral interferon response (IFN-γ, IFN-λ, IFN-α2a, IP10, ITAC). In therapeutic studies in the future, it may be possible to document levels of drug (pharmacokinetics) in nasal MLF.

Conditions

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Bronchiolitis Bronchiolitis, Viral RSV Infection Respiratory Failure

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Emergency Department

Babies with suspected respiratory tract infection (RTI) in the ED

Group Type OTHER

Nasal and Bronchial Sampling

Intervention Type DIAGNOSTIC_TEST

Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.

Paediatric Wards

Babies with diagnosed RSV infection admitted to paediatric wards

Group Type OTHER

Nasal and Bronchial Sampling

Intervention Type DIAGNOSTIC_TEST

Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.

Paediatric Intensive Care

Babies with diagnosed severe RSV infection in PICU requiring mechanical ventilation

Group Type OTHER

Nasal and Bronchial Sampling

Intervention Type DIAGNOSTIC_TEST

Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.

Health Controls

Babies without respiratory symptoms, attending routine outpatient appointments or undergoing elective surgical procedures

Group Type OTHER

Nasal and Bronchial Sampling

Intervention Type DIAGNOSTIC_TEST

Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.

Controls in Paediatric Intensive Care

Babies without RSV infection but requiring mechanical ventilation in PICU

Group Type OTHER

Nasal and Bronchial Sampling

Intervention Type DIAGNOSTIC_TEST

Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.

Interventions

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Nasal and Bronchial Sampling

Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Infants aged 2 weeks-24 months
* Presentation to the Emergency Department with any upper respiratory tract infection (URTI) in the RSV season (Oct-March).

OR • Documented RSV infection, admitted to the paediatric wards at St Mary's Hospital.


* Hospitalised Infants admitted to the PICU at St. Mary's Hospital, aged 2 weeks-24 months with documented RSV infection (by rapid test and/or PCR).
* Infants of weight \>2kg.
* On a conventional ventilator with an Endotracheal Tube (ETT) of \>3.0mmm diameter


• Babies, aged 2 weeks-24 months, attending routine outpatient appointments or undergoing elective surgical procedures.


* Infants aged 2 weeks-24 months.
* Infants ventilated on the PICU for any condition
* Confirmed RSV negative by PCR of respiratory tract samples

Exclusion Criteria

* Any local or systemic factor that would influence the safety of nasal sampling.
* Bilateral indwelling nasal catheters or local nasal pathology preventing access for nasal sampling.
* Bleeding disorders.
* The baby is taking part in another interventional study.
* The parents or guardians not able to sign the informed consent from due to limited English or comprehension despite the use of independent interpreter services.
* Limited life expectancy of the baby,

Group 3


* Any local or systemic factor that would influence the safety of nasal sampling.
* Bilateral nasal catheters or local nasal pathology preventing access for nasal sampling.
* The baby is taking part in another interventional study.
* Prematurity - corrected gestational age \<36 weeks, weight \<2kg
* Significant hypoxia or instability precluding ventilator disconnection
* ETT \< 3mm internal diameter
* Transcutaneous oxygen saturation of \<95% on 60% oxygen
* Risk of bleeding
* Pneumothorax
* Infants receiving oral corticosteroid therapy at any time in past month
* Parents or guardians not able to sign informed consent from due to limited English or understanding despite the use of independent interpreter services.
* Limited life expectancy or a decision to limit management,


* Any respiratory symptoms
* All other exclusion are the same as Groups 1 and 2

Control Group 2


* All exclusions are the same as Group 3
* In addition - any concern about raised intracranial pressure
Minimum Eligible Age

2 Weeks

Maximum Eligible Age

2 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Pulmocide Ltd

INDUSTRY

Sponsor Role collaborator

Imperial College Healthcare NHS Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Imperial College NHS Healthcare Trust

London, , United Kingdom

Site Status

Countries

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United Kingdom

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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15/WM/0343

Identifier Type: -

Identifier Source: org_study_id

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