CHEST Guidelines-Etiologies of Chronic Cough in Pediatric Cohorts

Etiologies of Chronic Cough in Pediatric Cohorts

Pdf Summary

The CHEST Guideline and Expert Panel Report conducted a systematic review to understand the causes (etiologies) of chronic cough in children aged 14 years or younger and to examine the potential relationship between obstructive sleep apnea (OSA) and chronic cough in children. 

<strong>Key Findings:</strong>

1. <strong>Differences from Adults:</strong> Moderate-quality evidence indicates that the causes of chronic cough in children are distinct from those in adults, being influenced by age and setting. For example, asthma, protracted bacterial bronchitis (PBB), and natural resolution were common causes in children, while chronic bronchitis or idiopathic causes, prevalent in adults, were not common in children.

2. <strong>Age and Regional Factors:</strong> The etiologies of chronic cough vary by age and region due to different environmental factors and health conditions, such as tuberculosis or pulmonary eosinophilia in less affluent settings. 

3. <strong>OSA and Chronic Cough:</strong> There is limited evidence on the connection between OSA and chronic cough in children, with data primarily from case reports and cross-sectional studies. The panel suggests managing children with suspected OSA using established pediatric sleep guidelines.

<strong>Recommendations:</strong>

1. Pediatric chronic cough should not be assumed to share common etiologies with adult chronic cough.
2. Clinicians should consider the child’s age and the clinical setting when evaluating and managing chronic cough.
3. Research should employ standardized, validated cough outcomes and account for natural cough resolution over time (period effects).

<strong>Conclusion:</strong>

Chronic cough in children requires specific management strategies that differ from adult approaches. The panel underscores the importance of considering the age and setting in evaluating chronic cough and suggests further research on the relationship between OSA and chronic cough in children.

Keywords

chronic cough

children

obstructive sleep apnea

asthma

protracted bacterial bronchitis

age factors

regional factors

pediatric guidelines

cough management

research recommendations