Wiener klinische Wochenschrift

, Volume 126, Issue 13–14, pp 439–450 | Cite as

Konsensuspapier zur Evaluation und Therapie des chronischen Hustens in der Pädiatrie

  • Angela Zacharasiewicz
  • Ernst Eber
  • Josef Riedler
  • Thomas Frischer
konsensus bericht

Zusammenfassung

Hintergrund

Bisher existieren im deutschsprachigen Raum keine Leitlinien zur Evaluation und Therapie des chronischen Hustens.

Ziel dieser Arbeit ist nach Literatur-Suche zu relevanten Publikationen und Leitlinien zum Thema „chronischer Husten beim Kind“ eine aktuelles Statement der Österreichischen Gesellschaft für Kinder- und Jugendheilkunde und der Österreichischen Gesellschaft für Pneumologie zu Evaluation und Therapie des chronischen Hustens beim Kind sowie einen praktischer Algorithmus zu geben. Ziel ist auch chronischen Husten deutlich von obstruktiven Atemwegserkrankungen abzugrenzen und die möglichen Differenzialdiagnosen anhand wesentlicher anamnestischer und klinischer Merkmale zu beschreiben und einen Überblick über die therapeutischen Möglichkeiten zu geben. Die subjektive Komponente des Symptoms und die schwierige Objektivierung werden diskutiert.

Methoden

Eine Cochrane und Medline Suche wurde durchgeführt und die relevante Literatur bis Mai 2013 inkludiert.

Ergebnisse

Kindlicher chronischer Husten wird definiert als Husten täglich über 4 Wochen. Bei einer Dauer von 3-8 Wochen Husten kann man auch von prolongiertem subakutem Husten sprechen. Chronischer Husten kann spezifische Ursachen haben und sich als Symptom einer Grunderkrankung darstellen. Diese gilt es herauszufinden und adäquat zu behandeln. Daneben existiert der nicht spezifische Husten, der erst nach Ausschluss jeder anderen spezifischen Ursache diagnostiziert werden kann. Jeglicher Therapieversuch bei chronischem Husten muss re-evaluiert und die Wirksamkeit überprüft werden.

Wichtig bei der Diagnostik sind auch das elterliche Verständnis der Ätiologie des Hustens im Allgemeinen und der Zusammenhang von Umwelteinflüssen und chronischem Husten beim Kind.

Schlussfolgerung

Chronischer Husten bedarf einer detaillierten Aufarbeitung, um möglichen Ursachen adäquat zu begegnen; bei Fehlen einer Diagnose und Fortbestehen der Beschwerden empfiehlt sich dringend eine Abklärung in einem auf Pädiatrische Pneumologie spezialisierten Zentrum.

Schlüsselwörter

Husten Chronischer Husten Kinder Konsensus Evaluation Therapie 

Consensus statement on the evaluation and therapy of chronic cough in children

Summary

Background

Currently no consensus guidelines on the evaluation and therapy of chronic cough in children have been published in German.

Aim of this study was therefore, after a literature search on all relevant publications and guidelines concerning chronic cough in children, to publish a Statement of the Austrian Society of Pediatrics and The Austrian Society of Pneumology on the evaluation and therapy of chronic childhood cough and to publish a practice based approach. Aim was also to differentiate cough clearly from obstructive airway diseases and to summarize all relevant differential diagnosis using relevant patient history and clinical characteristics and give an overview of therapeutical approaches. The subjective component of cough and the difficulty to assess cough in an objective manner is discussed.

Methods

A Cochrane and Medline Search were performed on all relevant literature until Mai 2013.

Results

Chronic cough in children is defined as daily cough for more than 4 weeks. Duration of 3 to 8 weeks is sometimes called prolonged or sub-acute cough. Chronic cough may have specific cause and may be a symptom of an underling disease, which needs to be found and treated adequately. Unspecific cough may only be diagnosed after exclusion of all other causes. Any therapeutical approach needs to be re- evaluated and efficacy needs to be reviewed. Parental understanding of the etiology of cough in general and the influence of environmental exposures is essential for diagnosis.

Conclusion

Chronic cough needs a detailed history and various differential diagnoses need to be taken in consideration. Children with persistent complaints without a proper diagnosis need to be seen in a center specialized in Pediatric Respiratory Medicine.

Keywords

Cough Chronic cough Children Guideline Evaluation Treatment 

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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Angela Zacharasiewicz
    • 1
  • Ernst Eber
    • 2
  • Josef Riedler
    • 3
  • Thomas Frischer
    • 1
  1. 1.Abteilung für Kinder und JugendheilkundeLehrkrankenhaus – Wilhelminenspital der Stadt WienWienÖsterreich
  2. 2.Klinische Abteilung für pädiatrische Pulmonologie und Allergologie, Univ.-Klinik für Kinder- und JugendheilkundeMedizinische Universität GrazGrazÖsterreich
  3. 3.Kinder- und Jugendspital SchwarzachSchwarzach im PongauÖsterreich

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