CHEST Guidelines-Managing-Chronic-Cough-as-a-Symptom-in-Children-an (1)

Managing-Chronic-Cough-as-a-Symptom-in-Children-an (1)
Pdf Summary
The CHEST Expert Panel Report on Managing Chronic Cough in Children aims to provide updated guidelines for evaluating and managing chronic cough in children, improving on the 2006 guidelines. Chronic cough in children, defined as a cough lasting more than four weeks, represents a common symptom that differs from adults in causes and implications. The panel reviewed systematic evidence and expert opinions to formulate recommendations.

Key points from the report include:
1. <strong>Definition and Causes</strong>: Chronic cough in children is defined as a daily cough persisting for more than four weeks. The causes differ from adults and vary with age and clinical settings.
2. <strong>Management Protocols</strong>: Pediatric-specific cough management protocols or algorithms are recommended to guide diagnosis and treatment. Evaluation should aim at defining the cough's etiology, involving a thorough clinical assessment, chest radiograph, and spirometry.
3. <strong>Evaluation Approaches</strong>: Clinical history and examination should distinguish between specific and non-specific coughs. Specific coughs suggest underlying conditions needing further investigation, whereas non-specific coughs may resolve without treatment.
4. <strong>Investigations</strong>: Extensive testing beyond basic evaluations isn't usually recommended unless dictated by specific clinical signs. Tests for diseases, like pertussis, should be based on clinical suspicion.
5. <strong>Therapy and Management</strong>: Empirical treatments are discouraged unless symptoms specifically indicate certain conditions, such as rhinosinus issues or asthma. Treatment should be etiology-based, with management of exacerbating factors like tobacco smoke exposure.
6. <strong>Parental Involvement</strong>: Addressing parental expectations and concerns is crucial, as chronic cough impacts family quality of life.
7. <strong>Non-Specific Cough Treatments</strong>: There is insufficient evidence for symptomatic treatments. If empirical treatments are trialed, they should have clearly defined periods for effectiveness evaluation.

Overall, the guidelines emphasize using evidence-based management that considers the unique pediatric aspects of chronic cough and prioritizes the differential diagnoses that are distinct from adult cases. Further studies are called for, especially in primary care settings, to optimize these management pathways.
Keywords
chronic cough
children
guidelines
management
evaluation
etiology
pediatric
treatment
parental involvement
evidence-based