Bronchiolitis Recovery and the Use of High Efficiency Particulate Air (HEPA) Filters

NCT ID: NCT05615870

Last Updated: 2025-10-02

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

230 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-07

Study Completion Date

2024-07-19

Brief Summary

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This is a multi-center, parallel, double-blind, randomized controlled clinical trial. Children \<12 months of age hospitalized with bronchiolitis are randomized 1:1 to receive a 24-week home intervention with filtration units containing HEPA and carbon filters (in the child's sleep space and a common room) to improve indoor air quality (IAQ) or to a control group with filtration units without HEPA and carbon filters. The HEPA intervention units and control units will be used for 24 weeks after pre-intervention IAQ measurements. Children are followed for respiratory outcomes over the pre-intervention and intervention periods.

Detailed Description

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This is a multi-center, parallel, double-blind, randomized controlled clinical trial. Two hundred twenty-eight children \<12 months old with their first hospitalization for bronchiolitis will be randomized 1:1 (stratified by site) to receive 24 weeks of home intervention with active HEPA filtration units to improve IAQ or to a control group without a HEPA or carbon filter inside identical-appearing units. Children will be followed for respiratory symptoms during a pre-intervention period of up to two weeks following randomization and during an intervention period of 24 weeks.

This study is designed to reduce barriers to participation for rural participants in that there will be no required study visits to a distant study site, and all study activities and data collection will be conducted remotely. Participants will be identified in hospitals in ISPCTN states, maximizing the chances that rural and medically underserved populations are represented. It is common for rural children with bronchiolitis to be transferred to tertiary care centers in urban/suburban locales, so inclusion of urban hospitals will allow for recruitment of this population.1 It is important for rural children to be represented in a bronchiolitis study in order to increase generalizability. Rural and underserved children have a higher risk of decreased access to medical care for symptoms and illness episodes, and a higher burden of asthma.83,84 These families may have air pollutant exposure profiles distinct from those residing in urban areas. For example, they might experience less exposure to traffic-related pollutants but may have more wood stove use or exposure to agricultural pollutants or wildfires. With its diversity of sites, the ECHO ISPCTN is well-positioned to enroll rural children that might otherwise be excluded.

Conditions

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Bronchiolitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a multi-center, parallel, double-blind, randomized controlled clinical trial
Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Investigators
Families will be masked as to whether their Winix units are equipped with or without HEPA/carbon filters.

Study coordinators, investigators, and other team members who interact with participants' parent(s)/guardian(s) to obtain surveys, troubleshoot equipment setup and operation, or have other interactions will remain masked through the duration of the study for individual participants. This includes masking as to which intervention the participants receive and household air quality measurements, including the baseline measurements (separate personnel will need to be on the receiving end for air quality measurement data). This will require more than one study coordinator or additional staff/technician on the study team.

Study Groups

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Intervention Group (Active Filter)

The intervention group will use two Winix 5500-2 HEPA filtration units (Appendix A) (https://winixamerica.com/product/5500-2/). One will be placed in the child's sleep space and one will be placed in another common room with both units running continuously on the "high" (i.e., level 3 / second from highest) setting. Each unit is 8.2 x 15.0 x 23.6 inches, and verified for a 360 sq. foot room. If a home is too small to accommodate 2 Winix units (for example, a single room residence'), one Winix unit may be used for the study. Additional features beyond HEPA and carbon filter, include plasmawave technology to reduce volatile organic compounds and odors. The plasmawave feature will be turned off to avoid ozone production.

Group Type ACTIVE_COMPARATOR

Winix 5500-2 HEPA filtration units

Intervention Type OTHER

To determine if use of a HEPA filtration unit home intervention reduces the respiratory symptom burden (symptom-free days; SFD) for 24 weeks compared to a use of a control unit.

Control Group (No Filter)

The control group will use identical-appearing Winix 5500-2 units and identical setup procedures as described above, but with no HEPA or carbon filters.

Group Type SHAM_COMPARATOR

Winix 5500-2 HEPA filtration units

Intervention Type OTHER

To determine if use of a HEPA filtration unit home intervention reduces the respiratory symptom burden (symptom-free days; SFD) for 24 weeks compared to a use of a control unit.

Interventions

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Winix 5500-2 HEPA filtration units

To determine if use of a HEPA filtration unit home intervention reduces the respiratory symptom burden (symptom-free days; SFD) for 24 weeks compared to a use of a control unit.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age \<12 months at hospital admission
* First-time hospitalization for bronchiolitis
* One primary residence (\>5 days per week)
* Parent, legal guardian or other legally authorized representative consents to allow their child to participate and agrees to participate in all study activities
* Electricity in the home (required to power the study equipment)
* Wireless internet access or cellular service access in the home\*
* English or Spanish-speaking parent or guardian

Exclusion Criteria

* Chronic airway or respiratory conditions requiring home oxygen, mechanical ventilation, or tracheostomy dependence; known immunodeficiency, hemodynamically significant cardiac conditions including those requiring medication or oxygen; cystic fibrosis; neuromuscular disease; eligible for palivizumab (per AAP guidelines87)
* Use of stand-alone home HEPA filtration other than study-related HEPA units in the home
* Household member who smokes (any type), vapes, or uses e-cigarettes
* Intention to move in the next 6 months
* Enrolled or plans to enroll in an interventional clinical trial for treatment of acute bronchiolitis or sequelae of bronchiolitis, unless permission given by the PI
* Another child in the household is enrolled in this study (one child per household can enroll)
Minimum Eligible Age

1 Week

Maximum Eligible Age

12 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Vermont Medical Center

OTHER

Sponsor Role collaborator

University of Montana

OTHER

Sponsor Role collaborator

National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

IDeA States Pediatric Clinical Trials Network

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kelly Cowan, MD

Role: STUDY_CHAIR

University of Vermont Medical Center

Erin Semmens, PhD, MPH

Role: STUDY_CHAIR

University of Montana

Locations

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Alaska Native Tribal Health Consortium

Anchorage, Alaska, United States

Site Status

Arkansas Children's Hospital - Little Rock (ACHRI)

Little Rock, Arkansas, United States

Site Status

Kapi'olani Medical Center for Women and Children

Honolulu, Hawaii, United States

Site Status

Kansas University Medical Center

Kansas City, Kansas, United States

Site Status

University of Louisville

Louisville, Kentucky, United States

Site Status

Tulane University, Department of Pediatrics

New Orleans, Louisiana, United States

Site Status

University of Miss. Medical Center

Jackson, Mississippi, United States

Site Status

University of Montana

Missoula, Montana, United States

Site Status

University of Nebraska Medical Center

Omaha, Nebraska, United States

Site Status

Dartmouth Hospital

Lebanon, New Hampshire, United States

Site Status

University of New Mexico Health Sciences Center

Albuquerque, New Mexico, United States

Site Status

Children's Hospital OU Medical Center

Oklahoma City, Oklahoma, United States

Site Status

Rhode Island Hospital

Providence, Rhode Island, United States

Site Status

Prisma Health-Midlands

Columbia, South Carolina, United States

Site Status

Avera Research Institute

Sioux Falls, South Dakota, United States

Site Status

University of Vermont Medical Center

Burlington, Vermont, United States

Site Status

West Virginia University

Morgantown, West Virginia, United States

Site Status

Countries

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United States

References

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Cowan K, Semmens EO, Lee JY, Walker ES, Smith PG, Fu L, Singleton R, Cox SM, Faiella J, Chassereau L, Lawrence L, Ying J, Baldner J, Garza M, Annett R, Chervinskiy SK, Snowden J. Bronchiolitis recovery and the use of High Efficiency Particulate Air (HEPA) Filters (The BREATHE Study): study protocol for a multi-center, parallel, double-blind, randomized controlled clinical trial. Trials. 2024 Mar 20;25(1):197. doi: 10.1186/s13063-024-08012-0.

Reference Type DERIVED
PMID: 38504367 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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U24OD024957

Identifier Type: NIH

Identifier Source: secondary_id

View Link

274137

Identifier Type: -

Identifier Source: org_study_id

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