Chronic Cough Related to Acute Viral Bronchiolitis in Children: CHEST Expert Panel Report

Chest: The Journal of Circulation, Respiration and Related Systems

Miles Weinberger^5¹  Richard S. Irwin^6²  Bruce K. Rubin^4³  Anne B. Chang^1,2⁴  Todd M. Adams⁵  John J. Oppenheimer^3⁶ 

[1] Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA^4;Department of Pediatrics, University of California San Diego, Rady Children’s Hospital, San Diego, CA^5;Division of Allergy and Immunology, Department of Medicine, New Jersey Medical School, Pulmonary and Allergy Associates, Morristown, NJ^3;Division of Child Health, Menzies School of Health Research, Darwin, Australia^1;Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, UMass Memorial Medical Center, Worcester, MA^6;Respiratory and Sleep Department, Lady Cilento Children’s Hospital, Qld Uni of Technology, Brisbane, QLD, Australia^2

关键词: cough;    evidence-based medicine;    guidelines;    KQ;    key question;    RCT;    randomized controlled trial;   

DOI  :  10.1016/j.chest.2018.04.019

学科分类：呼吸医学

来源: American College of Chest Physicians

【 摘 要 】

Background Acute bronchiolitis is common in young children, and some children develop chronic cough after their bronchiolitis. We thus undertook systematic reviews based on key questions (KQs) using the PICO (Population, Intervention, Comparison, Outcome) format. The KQs were: Among children with chronic cough (> 4 weeks) after acute viral bronchiolitis, how effective are the following interventions in improving the resolution of cough?: (1) Antibiotics. If so what type and for how long? (2) Asthma medications (inhaled steroids, beta₂ agonist, montelukast); and (3) Inhaled osmotic agents like hypertonic saline? Methods We used the CHEST expert cough panel's protocol and the American College of Chest Physicians (CHEST) methodological guidelines and GRADE framework. Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context were used to form these suggestions. Delphi methodology was used to obtain consensus. Results Several studies and systematic reviews on the efficacy of the three types of interventions listed in the introduction were found but no data were relevant to our KQs. Thus, no recommendations on using the interventions above could be formulated. Conclusions The panel made several consensus-based suggestions and identified directions for future studies to advance the field of managing chronic cough post-acute bronchiolitis in children.

【 授权许可】

CC BY