Leitlinie der Deutschen Gesellschaft für Pneumologie zur Diagnostik und Therapie von Patienten mit akutem und chronischem Husten

Inhalt Seite 1 Struktur der Leitlinie 571 Präambel 571 1.1 Schema der Leitlinienentwicklung 571 1.2 Klinische Evidenz der Leitlinie 572 1.3 Klinische Algorithmen 572 1.4 Teilnahme von Industrievertretern 573 1.5 Veröffentlichung, Verbreitung und Aktualisierung der Leitlinie 573 1.6 Sponsoring 573 2 Epidemiologie 573 3 Anmerkungen zur Physiologie des Hustens 573 3.1 Der Hustenreflex 573 3.2 Husten und Bronchospasmus 574 3.3 Produktiver und nicht-produktiver Husten 574 3.4 Eigenschaften des Auswurfs 574 4 Ursachen und Klassifizierung des Hustens 575 5 Akuter Husten: die wichtigsten Krankheitsbilder 576 5.1 Infektiöse Erkrankungen der oberen Atemwege 576 5.2 Allergische Erkrankungen der oberen Atemwege 576 5.3 Asthma 576 5.4 Aspiration 576 5.5 Akute inhalative Intoxikationen (Unfälle am Arbeitsplatz, Rauchgasvergiftungen) 576 5.6 Postinfektiöser Husten 576 5.7 Pneumonie 577 5.8 Pleuritis 577 5.9 Lungenembolie 577 5.10 Pneumothorax 577 5.11 Akute Linksherzinsuffizienz 577 5.12 AV Block II. und III. Grades 577 6 Chronischer Husten: die wichtigsten Krankheitsbilder 577 6.1 Asthma 577 6.2 COPD 577 6.3 Bronchialtumoren 578 6.4 Aspiration 578 6.5 Diffuse Lungenparenchymerkrankungen - Systemerkrankungen mit Lungenbeteiligung 579 6.6 Seltene isolierte Erkrankungen des Tracheobronchialsystems 579 6.6.1 Tracheo-Bronchomegalie (M. Mounier-Kuhn) 579 6.6.2 Tracheobronchiale Amyloidose 579 6.6.3 Rezidivierende Polychondritis 579 6.6.4 Tracheobronchopathia osteoplastica 580 6.6.5 Juvenile laryngotracheale Amyloidose 580 6.7 RADS (Reactive airways dysfunction syndrome) 580 6.8 VCD (Vocal cord dysfunction) 580 6.9 Tuberkulose 580 6.10 Keuchhusten 581 6.11 Linksherzinsuffizienz 581 6.12 Endokarditis 581 6.13 Husten als Nebenwirkung einer medikamentösen kardialen Therapie 581 7 Chronisch persistierender Husten (CPH) 581 7.1 Erkrankungen im Bereich von Nase und Nebenhöhlen 582 7.2 Erkrankungen im Bereich von Pharynx und Larynx 582 7.3 Husten als Asthmaäquivalent 582 7.4 Gastroösophageale Refluxkrankheit 583 7.5 Chronische, nicht obstruktive Bronchitis 584 7.6 Bronchiektasen 584 7.7 Chronischer Husten unklarer Ursache 585 7.8 Psychogener Husten 585 7.9 Husten als Nebenwirkung von Medikamenten 585 7.10 Bronchomalazie 586 7.11 Eosinophile Bronchitis 586 7.12 Zystische Fibrose 586 8 Diagnostik 586 8.1 Akuter Husten 587 8.2 Chronischer Husten 589 8.3 Ambulante und stationäre Diagnostik 590 8.4 Nebenwirkungen, Komplikationen und Kosten der Diagnostik 590 8.5 Zusammenfassung der wichtigsten Empfehlungen zur Diagnostik 590 9 Häufige Fehler bei der Stufendiagnostik des Hustens 590 10 Therapie 591 10.1.1 Physiotherapie bei produktivem Husten 591 10.1.2 Physiotherapie bei unproduktivem Husten 592 10.1.3 Atemphysiotherapie unter Zuhilfenahme von Geräten 592 10.2 Hustentherapeutika mit Wirkung am Hustenrezeptor 592 10.2.1 Expektorantien 593 10.2.2 Medikamente, die die Schleimproduktion verringern 593 10.2.3 Medikamente zur Steigerung der mukoziliären Clearance 593 10.2.4. Medikamente zur Reduktion der Reizung der Hustenrezeptoren 594 10.2.5 Schleimhautabschwellende Substanzen 594 10.2.6 Antibiotika 594 10.2.7 Entzündungshemmende Substanzen 595 10.3 Hustentherapeutika mit Wirkung am Hustenreflexbogen: Lokalanästhetika 595 10.4 Zentral wirksame Antitussiva 595 10.5 Hustentherapeutika mit Wirkung am Effektororgan 595 11 Komplikationen des Hustens 595 Anhang 1 Teilnehmerliste der Konsensustreffen 596 Anhang 2 Ableitung von Qualitätsindikatoren aus der Leitlinie Husten 596 Anhang 3 Zusammenfassung der Leitlinie 597

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