Pneumologie 2015; 69(10): 588-594
DOI: 10.1055/s-0034-1392616
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Was ist für die Diagnostik und Therapieverlaufskontrolle von chronischem Husten wichtig?

What is Important for Diagnosis and Therapy Follow-up in Chronic Cough?
U. Koehler
1   Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
,
O. Hildebrandt
1   Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
,
U. Walliczek
2   Klinik für HNO, Philipps-Universität, Marburg
,
L. Höhle
3   Thora Tech GmbH, Gießen
,
A. Weissflog
3   Thora Tech GmbH, Gießen
,
J. Heselhaus
3   Thora Tech GmbH, Gießen
,
S. Kerzel
4   Klinik für Pädiatrische Pneumologie und Allergologie, Universitäts-Kinderklinik Ostbayern am KUNO-Standort St. Hedwig, Regensburg
,
C. Urban
4   Klinik für Pädiatrische Pneumologie und Allergologie, Universitäts-Kinderklinik Ostbayern am KUNO-Standort St. Hedwig, Regensburg
,
K. Sohrabi
5   Fachbereich GES, Technische Hochschule Mittelhessen, Gießen
,
V. Gross
5   Fachbereich GES, Technische Hochschule Mittelhessen, Gießen
› Author Affiliations
Further Information

Publication History

eingereicht 10 June 2015

akzeptiert nach Revision 03 July 2015

Publication Date:
07 October 2015 (online)

Zusammenfassung

Auf dem Gebiet der Analyse chronischen Hustens sind in den letzten Jahren erhebliche Fortschritte gemacht worden. Bislang erfolgte die Erfassung und Beurteilung von chronischem Husten primär subjektiv anhand von Fragebögen und Tagebüchern. Die Beurteilung von chronischem Husten sowie dessen Therapie sollte zukünftig, insbesondere unter evidenzbasierten Kriterien, einer Kombination aus objektiven und subjektiven Kriterien unterzogen werden. Objektive Kriterien leiten sich dabei aus einer 24 h-Hustenregistrierung und Hustenprovokationsmessung (Hypersensitivität) ab, subjektive aus der Bewertung gut validierter Fragebögen zu Husten und Lebensqualität. Hinsichtlich der 24 h-Langzeitregistrierung von Husten sollte primär die Hustenfrequenz erfasst werden. Weitere diagnostische Optionen der Feinanalyse (produktiver, nicht-produktiver Husten) sind gegeben.

Abstract

Within the last years there has been significant progress in the field of chronic cough. So far, the analysis and evaluation of chronic cough was done mainly on the basis of subjective methods such as manual counts of cough events, questionnaires and diaries. Testing cough hypersensitivity and monitoring 24 h cough represent objective criteria. Validated questionnaires on cough frequency and quality of life represent the impact of chronic cough. Cough frequency monitoring, the preferred tool to objectively assess cough, should be used as primary end-point in clinical trials. It will also be possible to discriminate between productive and non-productive cough. The relationship with subjective measures of cough is weak. In the future, cough and its therapy should therefore be assessed with a combination of subjective and objective tools.

 
  • Literatur

  • 1 Köhler D. Physiology and Pathophysiology of Cough. Pneumologie 2008; 62 (Suppl. 01) 14-17
  • 2 Greenberg H, Cohen RI. Nocturnal asthma. Curr Opin Pulm Med 2012; 18: 57-62
  • 3 Chan KKY, Ing AJ, Laks L et al. Chronic cough in patients with sleep-disordered breathing. Eur Respir J 2010; 35: 368-372
  • 4 Decalmer S, Stovold R, Houghton LA et al. Chronic cough: relationship between microaspiration, gastroesophageal reflux, and cough frequency. Chest 2012; 142: 958-964
  • 5 Emilsson ÖI, Bengtsson A, Franklin KA et al. Nocturnal gastro-oesophageal reflux, asthma and symptoms of OSA: a longitudinal, general population study. Eur Respir J 2013; 1347-1354
  • 6 Dette F, Sohrabi K, Koch B et al. Overnight documentation of respiratory sounds in patients with chronic sinusitis. Med Klin 2010; 105: 695-697
  • 7 Palombini BC, Villanova CAC, Araujo E et al. A pathogenetic triad in chronic cough – Asthma, postnasal drip syndrome, and gastrooesophageal reflux disease. Chest 1999; 116: 279-284
  • 8 Brignall K, Jayaraman B, Birring SS. Quality of Life and Psychosocial Aspects of Cough. Lung 2008; 186: 55-58
  • 9 Lee KK, Birring SS. Cough and sleep. Lung 2010; 188: 91-94
  • 10 Widdicombe J. Neurophysiology of the cough reflex. Eur Resp J 1995; 8: 1193-1202
  • 11 Morice AH, Millqvist E, Belvisi MG et al. Expert opinion on the cough hypersensitivity syndrome in respiratory medicine. Eur Respir J 2014; 44: 1132-1148
  • 12 Morice AH, Jakes AD, Faruqi S et al. A worldwide survey of chronic cough: a manifestation of enhanced somatosensory response. Eur Respir J 2014; 44: 1149-1155
  • 13 Korpáš J, Sadloňová J, Vrabec M. Analysis of the Cough Sound: an Overview. Pulmonary Pharmacology 1996; 9: 261-268
  • 14 Yanagihara N, von Leden H, Werner-Kukuk E. The Physical Parameters of Cough: The Larynx in a Normal Single Cough. Acta oto-laryngologica 1966; 61: 495-510
  • 15 Marsden PA, Smith JS, Kelsall AA et al. A comparison of objective and subjective measures of cough in asthma. J Allergy Clin Immunol 2008; 122: 903-907
  • 16 Birring SS, Prudon B, Carr AJ et al. Development of a symptomatic specific health status measure for patients with chronic cough: Leicester Cough Questionnaire (LCQ). Thorax 2003; 58: 339-343
  • 17 Birring SS, Kavanagh J, Lai K et al. Adult and paediatric cough guidelines: Ready for an overhaul?. Pulmonary Pharmacology & Therapeutics 2015; 1-8
  • 18 Boulet LP, Coeytaux RR, McCrory DC et al. Tools for Assessing Outcomes in Studies of Chronic Cough. CHEST Guideline and Expert Panel report. Chest 2015; 147: 804-814
  • 19 Kardos P, Berck H, Fuchs KH et al. Guidelines of the German Respiratory Society for Diagnosis and Treatment of Adults Suffering from Acute or Chronic Cough. Pneumologie 2010; 64: 701-711
  • 20 Morice AH, Fontana GA, Belvisi MG et al. ERS guidelines on the assessment of cough. Eur Respir J 2007; 29: 1256-1276
  • 21 Pullerits T, Ternesten-Hasseus E, Johansson EL et al. Capsaicin cough threshold test in diagnostics. Respir Med 2014; 108: 1371-1376
  • 22 Birring SS, Fleming T, Matos S et al. The Leicester Cough Monitor: preliminary validation of an automated cough detection system in chronic cough. Eur Respir J 2008; 31: 1013-1018
  • 23 Koehler U, Brandenburg U, Weissflog A et al. LEOSound, an innovative procedure for acoustic long-term monitoring of asthma symptoms (wheezing and coughing) in children and adults. Pneumologie 2014; 86: 193-198
  • 24 Spinou A, Birring SS. An update on measurements and monitoring of cough: what are the important study endpoints?. J Thorac Dis 2014; 6: 728-734
  • 25 Gross V, Scholtes M, Sohrabi K et al. Validation of the LEOSound®-Monitor for standardized detection of cough and wheezing in children. Accepted for World-Sleep-Conference 2015. Istanbul: in press
  • 26 Smith JA, Decalmer S, Kelsall AA et al. Acoustic Cough – Reflux Associations in Chronic Cough: Potential Triggers and Mechanisms. Gastroenterology 2010; 139: 754-762
  • 27 Kunsch S, Gross V, Neesse A et al. Combined lung-sound and reflux-monitoring: a pilot study of a novel approach to detect nocturnal respiratory symptoms in gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2011; 33: 592-600
  • 28 Yousaf N, Monteiro W, Matos S et al. Cough frequency in health and disease. Eur Respir J 2013; 41: 241-243
  • 29 Janson C, Chinn S, Jarvis D et al. Determinants of cough in young adults participating in the European Community Respiratory Health Survey. Eur Respir J 2001; 18: 647-654
  • 30 Kelsall A, Decalmer S, McGuiness K et al. Sex differences and predictors of objective cough frequency in chronic cough. Thorax 2009; 64: 393-398
  • 31 Kelsall A, Houghton LA, Jones H et al. A novel approach to studying the relationship between subjective and objective measures of cough. Chest 2011; 139: 569-575
  • 32 Reinke C, Dette F, Gross V et al. Obscure coughing and the feeling of suffocation during sleep. Long-term nocturnal acoustic recording. Internist 2007; 48: 630-635
  • 33 Sundar KM, Daly SE. A longitudinal study of CPAP therapy for patients with chronic cough and obstructive sleep apnea. Cough 2013; 9: 19-25
  • 34 Yokohori N, Hasegawa M, Sato A et al. Utility of Continuous Positive Airway Pressure Therapy for Treating Chronic Coughs in Patients with Obstructive Sleep Apnea. Intern Med 2014; 53: 1079-1082