Kronik Öksürük ve Klinik Yaklaşım

Yıl 2016, Cilt: 8 Sayı: 5, 31 - 35, 30.09.2016

Mahir İğde

Öz

Öksürük değişik uyaranlara karşı havayollarının önemli savunma mekanizması olup,

havayollarının temizlenmesinde önemli bir rolü vardır. Öksürük refleksinin tam mekanizması

anlaşılamamıştır. Bir çok hastada öksürük önemsiz nedenlerden kaynaklanmasına

rağmen, hayat kalitesini olumsuz etkilediği için ve altta yatan ciddi hastalıkların bulgusu

olabileceği için özellikle kronik öksürük dikkatlice değerlendirilmelidir. Hastalara

etiyolojik sebebe göre tedavi edilmelidir. Çocukların küçük erişkinler olmadığı unutulmamalıdır.

Bu yüzden kronik öksürüğün değerlendirilmesi çocuklar ve erişkinler arasında

bir takım farklılıklar göstermektedir. Dikkatli hikaye alınması ve öksürük reseptörlerinin

anatomik dağılımına göre fizik muayene ilk yapılması gerekenlerdir. İkinci olarak

sık rastlanan etiyolojik sebepler (astım, gastroösofajialreflü ve postnasaldripsendromu)

araştırılmalı. Üçüncü basamakta daha az rastlanan sebepler araştırılmalı ve son olarak

tedavi planlanmalıdır. Hastalar değerlendirilirken bu süreçte hastalarının

Anahtar Kelimeler

Çocuklar, erişkinler, öksürük, kronik öksürük

Kaynakça

• 1. Morice AH. Epidemiology of cough. Pulmonary pharmacology & therapeutics. 2002;15(3):253-9. 2. French CL, Irwin RS, Curley FJ, Krikorian CJ. Impact of chronic cough on quality of life. Archives of Internal Medicine. 1998;158(15):1657-61. 3. İğde M, Öksüz BG. Çocuklarda Öksürük: Klinik Yaklaşım. Journal of Current Pediatrics/Guncel Pediatri. 2015;13(3). 4. Widdicombe J, Lee L-Y. Airway reflexes, autonomic function, and cardiovascular responses. Environmental health perspectives. 2001;109(Suppl 4):579. 5. Canning BJ, Mazzone SB, Meeker SN, Mori N, Reynolds SM, Undem BJ. Identification of the tracheal and laryngeal afferent neurones mediating cough in anaesthetized guineapigs. The Journal of physiology. 2004;557(2):543-58. 6. Haná ek J, Davies A, Widdicombe J. Influence of lung stretch receptors on the cough reflex in rabbits. Respiration. 1984;45(3):161-8. 7. Tatar M, Sant G, Sant F. Laryngeal and tracheobronchial cough in anesthetized dogs. Journal of applied physiology. 1994;76(6):2672-9. 8. Coleridge H, Coleridge J. Reflexes evoked from tracheobronchial tree and lungs. Comprehensive physiology. 1986. 9. Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines. Chest Journal. 2006;129(1_suppl):260S-83S. 10. Morice A. Review series: chronic cough: epidemiology. Chronic respiratory disease. 2008;5(1):43-7. 11. Ford AC, Forman D, Moayyedi P, Morice AH. Cough in the community: a cross sectional survey and the relationship to gastrointestinal symptoms. Thorax. 2006;61(11):975-9. 12. Zemp E, Elsasser S, Schindler C, Kunzli N, Perruchoud AP, Domenighetti G, et al. Long-term ambient air pollution and respiratory symptoms in adults (SAPALDIA study). American journal of respiratory and critical care medicine. 1999;159(4):1257-66. 13. Pavord ID, Chung KF. Management of chronic cough. The Lancet. 2008;371(9621):1375-84. 14. Corrao WM, Braman SS, Irwin RS. Chronic cough as the sole presenting manifestation of bronchial asthma. New England Journal of Medicine. 1979;300(12):633-7. 15. Shields MD, Bush A, Everard ML, McKenzie S, Primhak R. Recommendations for the assessment and management of cough in children. Thorax. 2008;63(Suppl 3):iii1-iii15. 16. Chung KF, Pavord ID. Prevalence, pathogenesis, and causes of chronic cough. The Lancet. 2008;371(9621):1364-74. 17. Irwin RS, Madison JM. Anatomical diagnostic protocol in evaluating chronic cough with specific reference to gastroesophageal reflux disease. The American journal of medicine. 2000;108(4):126-30. 18. Chatkin JM, Ansarin K, Silkoff PE, McCLEAN P, Gutierrez C, Zamel N, et al. Exhaled nitric oxide as a noninvasive assessment of chronic cough. American journal of respiratory and critical care medicine. 1999;159(6):1810-3. 19. Kahrilas PJ, Smith JA, Dicpinigaitis PV. A causal relationship between cough and gastroesophageal reflux disease (GERD) has been established: a pro/con debate. Lung. 2014;192(1):39-46. 20. Morice A, McGarvey L, Pavord I. Recommendations for the management of cough in adults. Thorax. 2006;61(suppl 1):i1-i24. 21. Morice A. The diagnosis and management of chronic cough. European Respiratory Journal. 2004;24(3):481-92. www.kliniktipdergisi.com 35 22. Irwin RS. Chronic cough due to gastroesophageal reflux disease: ACCP evidence-based clinical practice guidelines. CHEST Journal. 2006;129(1_suppl):80S-94S. 23. Chang AB, Lasserson TJ, Gaffney J, Connor FL, Garske LA. Gastrooesophageal reflux treatment for prolonged nonspecific cough in children and adults. The Cochrane Library. 2011. 24. Kahrilas PJ, Howden CW, Hughes N, Molloy-Bland M. Response of chronic cough to acid-suppressive therapy in patients with gastroesophageal reflux disease. CHEST Journal. 2013;143(3):605-12. 25. Wang T-Y, Lo Y-L, Liu W-T, Lin S-M, Lin T-Y, Kuo C-H, et al. Chronic cough and obstructive sleep apnoea in a sleep laboratory- based pulmonary practice. Cough. 2013;9(1):1. 26. Brightling CE, Pavord ID. Eosinophilic bronchitis: an imortant cause of prolonged cough. Annals of medicine. 2000;32(7):446-51. 27. Birring S, Passant C, Patel R, Prudon B, Murty G, Pavord I. Chronic tonsillar enlargement and cough: preliminary evidence of a novel and treatable cause of chronic cough. European Respiratory Journal. 2004;23(2):199-201. 28. Feldman JI, Woodworth WF. Cause for intractable chronic cough: Arnold's nerve. Archives of Otolaryngology–Head & Neck Surgery. 1993;119(9):1042-. 29. Decalmer S, Woodcock A, Greaves M, Howe M, Smith J. Airway abnormalities at flexible bronchoscopy in patients with chronic cough. European Respiratory Journal. 2007; 30(6):1138-42. 30. Haque RA, Usmani OS, Barnes PJ. Chronic idiopathic cough: a discrete clinical entity? CHEST Journal. 2005;127(5):1710-3. 31. Schroeder K, Fahey T. Should we advise parents to administer over the counter cough medicines for acute cough? Systematic review of randomised controlled trials. Archives of disease in childhood. 2002;86(3):170-5. 32. Morice AH, Menon MS, Mulrennan SA, Everett CF, Wright C, Jackson J, et al. Opiate therapy in chronic cough. American journal of respiratory and critical care medicine. 2007;175(4):312-5. 33. Ryan NM, Birring SS, Gibson PG. Gabapentin for refractory chronic cough: a randomised, double-blind, placebo-controlled trial. The Lancet. 2012;380(9853):1583-9. 34. Chang AB, Robertson CF, Van Asperen PP, Glasgow NJ, Mellis CM, Masters IB, et al. A multicenter study on chronic cough in children: burden and etiologies based on a standardized management pathway. CHEST Journal. 2012;142(4):943-50. 35. Marchant JM, Masters IB, Taylor SM, Cox NC, Seymour GJ, Chang AB. Evaluation and outcome of young children with chronic cough. CHEST Journal. 2006;129(5):1132-41. 36. Marchant J, Masters IB, Champion A, Petsky H, Chang AB. Randomised controlled trial of amoxycillin clavulanate in children with chronic wet cough. Thorax. 2012;67(8):689-93. 37. Kompare M, Weinberger M. Protracted bacterial bronchitis in young children: association with airway malacia. The Journal of pediatrics. 2012;160(1):88-92.