Çocuklarda Öksürük: Klinik Yaklaşım
Yıl 2015,
, 201 - 208, 01.12.2015
Mahir İğde
Banu Gülcan Öksüz
Öz
Öksürük önemli bir refleks savunma mekanizmasıdır ve çeşitli uyarılar ile havayollarının temizlenmesini sağlar. Çocuklar erişkinlere göre çevresel uyaranlara karşı daha hassastırlar. Öksürüğün tüm mekanizması henüz tam olarak belirlenememiştir. Kronik öksürüğün nedenleri çocuklarda erişkinlere göre farklılık göstermektedir. Çoğu çocukta öksürük normal bir olay olmasına rağmen; çeşitli ciddi hastalıkların belirtisi olabilir ve çocuğun hayat kalitesini etkilemesi nedeniyle önemsenmelidir. Tüm kronik öksürüğü olan çocuklar ayırıcı tanı için değerlendirilmelidir. Çocuklarda öksürüğün tedavisi etiyolojiye dayanılarak yapılmalıdır. Çocuklarda öksürükte semptomatik tedavinin etkisi olduğuna ait kanıt yoktur
Kaynakça
- 1. Irwin RS, Boulet LP, Cloutier MM, Fuller R, Gold PM, Hoffstein V, et al. Managing cough as a defense mechanism and as a symptom. A consensus panel report of the American College of Chest Physicians. Chest 1998;114(2 Suppl Managing):133-81.
- 2. Hay AD, Heron J, Ness A; ALSPAC study team. The prevalence of symptoms and consultations in pre-school children in the Avon Longitudinal Study of Parents and Children (ALSPAC): A prospective cohort study. Fam Pract 2005;22:367-74.
- 3. Curley FJ, Irwin RS, Pratter MR, Stivers DH, Doern GV, Vernaglia PA, et al. Cough and the common cold. Am Rev Respir Dis 1988;138:305-11.
- 4. Camner P, Mossberg B, Philipson K, Strandberg K. Elimination of test particles from the human tracheobronchial tract by voluntary coughing. Scand J Respir Dis 1979;60:56-62.
- 5. Puchelle E, Zahm JM, Girard F, Bertrand A, Polu JM, Aug F, et al. Mucociliary transport in vivo and in vitro. Relations to sputum properties in chronic bronchitis. Eur J Respir Dis 1980;61:254- 64.
- 6. Yeates DB, Aspin N, Levison H, Jones MT, Bryan AC. Mucociliary tracheal transport rates in man. J Appl Physiol 1975;39:487-95.
- 7. Irwin RS, Madison JM. Anatomical diagnostic protocol in evaluating chronic cough with specific reference to gastroesophageal reflux disease. Am J Med 2000;108(Suppl 4):126-30.
- 8. Bucher K. Pathophysiology and pharmacology of cough. Pharmacol Rev 1958;10:43-58.
- 9. Wolff AP, May M, Nuelle D. The tympanic membrane. A source of the cough reflex. JAMA 1973;223:1269.
- 10. Korpas J, Tomori Z. Cough and other respiratory reflexes. Basel: Switzerland: Karger company; 1979.
- 11. Widdicombe J. Airway receptors. Respir Physiol 2001;125:3-15.
- 12. Widdicombe JG, Undem BJ. Summary: Central nervous pharmacology of cough. Pulm Pharmacol Ther 2002;15:251-2.
- 13. Lee LY, Pisarri TE. Afferent properties and reflex functions of bronchopulmonary C-fibers. Respir Physiol 2001;125:47-65.
- 14. Canning BJ, Mazzone SB, Meeker SN, Mori N, Reynolds SM, Undem BJ. Identification of the tracheal and laryngeal afferent neurones mediating cough in anaesthetized guiena-pigs. J Physiol 2004;557:543-58.
- 15. Mazzone SB, Canning BJ, Widdicombe JG. In: Chung F, Widdicombe J, Boushey H (eds). Sensory pathways for the cough reflex. In Cough: Causes, Mechanisms and Therapy. Oxford: Blackwell Publishing; 2003. p.161-71.
- 16. Barnes PJ. Neurogenic inflammation in the airways. Respir Physiol 2001;125:145-54.
- 17. Karlsson JA. The role of capsaicin-sensitive C-fibre afferent nerves in the cough reflex. Pulm Pharmacol 1996;9:315-21.
- 18. Hanácek J, Davies A, Widdicombe JG. Influence of lung stretch receptors on the cough reflex in rabbits. Respiration 1984;45:161- 8.
- 19. Tatar M, Sant’Ambrogio G, Sant’Ambrogio FB. Laryngeal and tracheobronchial cough in anesthetized dogs. J Appl Physiol 1994;76:2672-9.
- 20. Coleridge HM, Coleridge JCG. Reflexes evoked from the tracheobronchial tree and lungs. In: Cherniak NS, Widdicombe JG (eds). Handbook of physiology. Bethesda Md: American Physiological Society; 1986.p.395-429.
- 21. Davis B, Roberts AM, Coleridge HM, Coleridge JC. Reflex tracheal gland secretion evoked by stimulation of bronchial C-fibers in dogs. J Appl Physiol Respir Environ Exerc Physiol 1982;53:985-91.
- 22. Johnson D, Osborne LM. Cough variant asthma: A review of the clinical literature. J Asthma 1991;28:85-90.
- 23. Munyard P, Bush A. How much coughing is normal? Arch Dis Child 1996;74:531-4.
- 24. Monto AS. Studies of the community and family: Acute respiratory illness and infection. Epidemiol Rev 1994;16:351-73.
- 25. Leder K, Sinclair MI, Mitakakis TZ, Hellard ME, Forbes A. A community based study of respiratory episodes in Melbourne, Australia. Aust N Z J Public Health 2003;27:399-404.
- 26. Shields MD, Bush A, Everard ML, McKenzie S, Primhak R; British Thoracic Society Cough Guideline Group. BTS guidelines: Recommendations for the assessment and management of cough in children. Thorax 2008;63(Suppl 3):15.
- 27. Chow PY, Ng DK. Chronic cough in children. Singapore Med J 2004;45:462-8.
- 28. Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines. Chest 2006;129:260-83.
- 29. Asilsoy S, Bayram E, Agin H, Apa H, Can D, Gulle S, et al. Evaluation of chronic cough in children. Chest 2008;134:1122-8.
- 30. No authors listed. Lung function testing: Selection of reference values and interpretative strategies. American Thoracic Society. Am Rev Respir Dis 1991;144:1202-18.
- 31. Cockcroft DW, Berscheid BA, Murdock KY. Unimodal distribution of bronchial responsiveness to inhaled histamine in a random human population. Chest 1983;83:751-4.
- 32. Parks DP, Ahrens RC, Humphries CT, Weinberger MM. Chronic cough in childhood: Approach to diagnosis and treatment. J Pediatr 1989;115:856-62.
- 33. Todokoro M, Mochizuki H, Tokuyama K, Morikawa A. Childhood cough variant asthma and its relationship to classic asthma. Ann Allergy Asthma Immunol 2003;90:652-9.
- 34. Holinger LD, Sanders AD. Chronic cough in infants and children: An update. Laryngoscope 1991;101:596-605.
- 35. Yellon RF, Coticchia J, Dixit S. Esophageal biopsy for the diagnosis of gastroesophageal reflux-associated otolaryngologic problems in children. Am J Med 2000;108(Suppl 4):131-8.
- 36. Paterson WG, Murat BW. Combined ambulatory esophageal manometry and dual-probe pH-metry in evaluation of patients with chronic unexplained cough. Dig Dis Sci 1994;39:1117-25.
- 37. Irwin RS, French CL, Curley FJ, Zawacki JK, Bennett FM. Chronic cough due to gastroesophageal reflux. Clinical, diagnostic, and pathogenetic aspects. Chest 1993;104:1511-7.
- 38. Irwin RS, Curley FJ, French CL. Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation and outcome of specific therapy. Am Rev Respir Dis 1990;141:640-7.
- 39. Smyrnios NA, Irwin RS, Curley FJ. Chronic cough with a history of excessive sputum production. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Chest 1995;108:991-7.
- 40. Chang AB. American College of Chest Physicians cough guidelines for children: Can its use improve outcomes? Chest 2008;134:1111-2.
- 41. Chang AB. Cough: are children really different from adults? Cough 2005;1:7.
- 42. Sato S, Saito J, Sato Y, Ishii T, Xintao W, Tanino Y, et al. Clinical usefulness of fractional exhaled nitric oxide for diagnosing prolonged cough. Respir Med 2008 ;102:1452-9.
- 43. Schroeder K, Fahey T. Should we advise parents to administer over the counter cough medicines for acute cough? Systematic review of randomized controlled trials. Arch Dis Child 2002;86:170-5.
Cough in Children: Clinical Approach
Yıl 2015,
, 201 - 208, 01.12.2015
Mahir İğde
Banu Gülcan Öksüz
Öz
Cough is an important reflex defense mechanism and it cleans the airways with the various stimuli. Children are more sensitive than adults to these environmental stimuli. Full mechanism of the cough reflex have not been completely analyzed. Causes of chronic cough in children are different from adults. Even cough is normal for most children, the presence of cough may be indicative of serious disorders and should be considered important because cough affects the child’s quality of life. All children with chronic cough should be evaluated for diagnosis. Cough in children should be treated based on etiology. There is no evidence of the affect of symptomatic treatment for cough in children
Kaynakça
- 1. Irwin RS, Boulet LP, Cloutier MM, Fuller R, Gold PM, Hoffstein V, et al. Managing cough as a defense mechanism and as a symptom. A consensus panel report of the American College of Chest Physicians. Chest 1998;114(2 Suppl Managing):133-81.
- 2. Hay AD, Heron J, Ness A; ALSPAC study team. The prevalence of symptoms and consultations in pre-school children in the Avon Longitudinal Study of Parents and Children (ALSPAC): A prospective cohort study. Fam Pract 2005;22:367-74.
- 3. Curley FJ, Irwin RS, Pratter MR, Stivers DH, Doern GV, Vernaglia PA, et al. Cough and the common cold. Am Rev Respir Dis 1988;138:305-11.
- 4. Camner P, Mossberg B, Philipson K, Strandberg K. Elimination of test particles from the human tracheobronchial tract by voluntary coughing. Scand J Respir Dis 1979;60:56-62.
- 5. Puchelle E, Zahm JM, Girard F, Bertrand A, Polu JM, Aug F, et al. Mucociliary transport in vivo and in vitro. Relations to sputum properties in chronic bronchitis. Eur J Respir Dis 1980;61:254- 64.
- 6. Yeates DB, Aspin N, Levison H, Jones MT, Bryan AC. Mucociliary tracheal transport rates in man. J Appl Physiol 1975;39:487-95.
- 7. Irwin RS, Madison JM. Anatomical diagnostic protocol in evaluating chronic cough with specific reference to gastroesophageal reflux disease. Am J Med 2000;108(Suppl 4):126-30.
- 8. Bucher K. Pathophysiology and pharmacology of cough. Pharmacol Rev 1958;10:43-58.
- 9. Wolff AP, May M, Nuelle D. The tympanic membrane. A source of the cough reflex. JAMA 1973;223:1269.
- 10. Korpas J, Tomori Z. Cough and other respiratory reflexes. Basel: Switzerland: Karger company; 1979.
- 11. Widdicombe J. Airway receptors. Respir Physiol 2001;125:3-15.
- 12. Widdicombe JG, Undem BJ. Summary: Central nervous pharmacology of cough. Pulm Pharmacol Ther 2002;15:251-2.
- 13. Lee LY, Pisarri TE. Afferent properties and reflex functions of bronchopulmonary C-fibers. Respir Physiol 2001;125:47-65.
- 14. Canning BJ, Mazzone SB, Meeker SN, Mori N, Reynolds SM, Undem BJ. Identification of the tracheal and laryngeal afferent neurones mediating cough in anaesthetized guiena-pigs. J Physiol 2004;557:543-58.
- 15. Mazzone SB, Canning BJ, Widdicombe JG. In: Chung F, Widdicombe J, Boushey H (eds). Sensory pathways for the cough reflex. In Cough: Causes, Mechanisms and Therapy. Oxford: Blackwell Publishing; 2003. p.161-71.
- 16. Barnes PJ. Neurogenic inflammation in the airways. Respir Physiol 2001;125:145-54.
- 17. Karlsson JA. The role of capsaicin-sensitive C-fibre afferent nerves in the cough reflex. Pulm Pharmacol 1996;9:315-21.
- 18. Hanácek J, Davies A, Widdicombe JG. Influence of lung stretch receptors on the cough reflex in rabbits. Respiration 1984;45:161- 8.
- 19. Tatar M, Sant’Ambrogio G, Sant’Ambrogio FB. Laryngeal and tracheobronchial cough in anesthetized dogs. J Appl Physiol 1994;76:2672-9.
- 20. Coleridge HM, Coleridge JCG. Reflexes evoked from the tracheobronchial tree and lungs. In: Cherniak NS, Widdicombe JG (eds). Handbook of physiology. Bethesda Md: American Physiological Society; 1986.p.395-429.
- 21. Davis B, Roberts AM, Coleridge HM, Coleridge JC. Reflex tracheal gland secretion evoked by stimulation of bronchial C-fibers in dogs. J Appl Physiol Respir Environ Exerc Physiol 1982;53:985-91.
- 22. Johnson D, Osborne LM. Cough variant asthma: A review of the clinical literature. J Asthma 1991;28:85-90.
- 23. Munyard P, Bush A. How much coughing is normal? Arch Dis Child 1996;74:531-4.
- 24. Monto AS. Studies of the community and family: Acute respiratory illness and infection. Epidemiol Rev 1994;16:351-73.
- 25. Leder K, Sinclair MI, Mitakakis TZ, Hellard ME, Forbes A. A community based study of respiratory episodes in Melbourne, Australia. Aust N Z J Public Health 2003;27:399-404.
- 26. Shields MD, Bush A, Everard ML, McKenzie S, Primhak R; British Thoracic Society Cough Guideline Group. BTS guidelines: Recommendations for the assessment and management of cough in children. Thorax 2008;63(Suppl 3):15.
- 27. Chow PY, Ng DK. Chronic cough in children. Singapore Med J 2004;45:462-8.
- 28. Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines. Chest 2006;129:260-83.
- 29. Asilsoy S, Bayram E, Agin H, Apa H, Can D, Gulle S, et al. Evaluation of chronic cough in children. Chest 2008;134:1122-8.
- 30. No authors listed. Lung function testing: Selection of reference values and interpretative strategies. American Thoracic Society. Am Rev Respir Dis 1991;144:1202-18.
- 31. Cockcroft DW, Berscheid BA, Murdock KY. Unimodal distribution of bronchial responsiveness to inhaled histamine in a random human population. Chest 1983;83:751-4.
- 32. Parks DP, Ahrens RC, Humphries CT, Weinberger MM. Chronic cough in childhood: Approach to diagnosis and treatment. J Pediatr 1989;115:856-62.
- 33. Todokoro M, Mochizuki H, Tokuyama K, Morikawa A. Childhood cough variant asthma and its relationship to classic asthma. Ann Allergy Asthma Immunol 2003;90:652-9.
- 34. Holinger LD, Sanders AD. Chronic cough in infants and children: An update. Laryngoscope 1991;101:596-605.
- 35. Yellon RF, Coticchia J, Dixit S. Esophageal biopsy for the diagnosis of gastroesophageal reflux-associated otolaryngologic problems in children. Am J Med 2000;108(Suppl 4):131-8.
- 36. Paterson WG, Murat BW. Combined ambulatory esophageal manometry and dual-probe pH-metry in evaluation of patients with chronic unexplained cough. Dig Dis Sci 1994;39:1117-25.
- 37. Irwin RS, French CL, Curley FJ, Zawacki JK, Bennett FM. Chronic cough due to gastroesophageal reflux. Clinical, diagnostic, and pathogenetic aspects. Chest 1993;104:1511-7.
- 38. Irwin RS, Curley FJ, French CL. Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation and outcome of specific therapy. Am Rev Respir Dis 1990;141:640-7.
- 39. Smyrnios NA, Irwin RS, Curley FJ. Chronic cough with a history of excessive sputum production. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Chest 1995;108:991-7.
- 40. Chang AB. American College of Chest Physicians cough guidelines for children: Can its use improve outcomes? Chest 2008;134:1111-2.
- 41. Chang AB. Cough: are children really different from adults? Cough 2005;1:7.
- 42. Sato S, Saito J, Sato Y, Ishii T, Xintao W, Tanino Y, et al. Clinical usefulness of fractional exhaled nitric oxide for diagnosing prolonged cough. Respir Med 2008 ;102:1452-9.
- 43. Schroeder K, Fahey T. Should we advise parents to administer over the counter cough medicines for acute cough? Systematic review of randomized controlled trials. Arch Dis Child 2002;86:170-5.