Zusammenfassung
Hintergrund
Ein Konsensuspapier zu Evaluation und Therapie des chronischen Hustens bei Kindern und Jugendlichen ist kürzlich in deutscher Sprache publiziert worden. Hier wird eine Zusammenfassung dieses ersten Konsensuspapiers der Österreichischen Gesellschaft für Kinder- und Jugendheilkunde und der Österreichischen Gesellschaft für Pneumologie präsentiert, die relevante differenzialdiagnostische Schritte und die Evidenz zum therapeutischen Management inkludiert.
Methoden
Cochrane- und Medline-Suchen wurden durchgeführt und die relevante Literatur bis Mai 2013 aufgenommen.
Ergebnisse
Kindlicher chronischer Husten wurde definiert als täglicher, über 4 Wochen anhaltender Husten. Bei einer Dauer von 3 bis 8 Wochen kann auch von prolongiertem subakutem Husten gesprochen werden. Chronischer Husten kann spezifische Ursachen haben und Symptom einer Grunderkrankung sein. Diese gilt es herauszufinden und dann adäquat zu behandeln. Daneben existiert der nichtspezifische Husten, der erst nach Ausschluss jeder anderen spezifischen Ursache diagnostiziert werden kann. Jeglicher Therapieversuch bei chronischem Husten muss reevaluiert und die Wirksamkeit überprüft werden. Das elterliche Verständnis der Ätiologie des Hustens sowie der Zusammenhang von Umwelteinflüssen und chronischem Husten beim Kind sind wesentlich für die Diagnose.
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.
Abstract
Background
A first consensus statement on the evaluation and therapy of chronic cough in children has recently been published in the German language. This article presents a summary of this consensus statement by the Austrian Society of Pediatric and Adolescent Medicine and the Austrian Society of Pneumology. A summary of relevant diagnostic procedures as well as an overview of the evidence of therapeutic approaches is presented. The subjective components of cough and the difficulty to assess cough in an objective manner are discussed.
Methods
A search in Cochrane and Medline databases was performed and relevant literature until May 2013 was included.
Results
Chronic cough in children is defined as daily coughing for more than 4 weeks. Coughing for 3–8 weeks is sometimes called prolonged or subacute cough. Chronic cough may have a specific cause and may be a symptom of an underlying disease, which needs to be found and treated adequately. Unspecific cough can only be diagnosed after exclusion of all other causes. Every therapeutic trial needs to be re-evaluated and the efficacy needs to be reviewed. Parental understanding of the etiology of coughing in general and the influence of environmental exposure is essential for diagnosis.
Conclusion
For children with chronic cough a detailed history is essential and various differential diagnoses need to be taken into consideration. Children with persistent complaints without a proper diagnosis need to be seen at a center specialized in pediatric respiratory medicine.
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Interessenkonflikt. A. Zacharasiewicz, E. Eber, J. Riedler und T. Frischer geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Zacharasiewicz, A., Eber, E., Riedler, J. et al. Evaluation und Therapie des chronischen Hustens bei Kindern. Monatsschr Kinderheilkd 163, 248–256 (2015). https://doi.org/10.1007/s00112-014-3305-4
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DOI: https://doi.org/10.1007/s00112-014-3305-4