Chest
Volume 154, Issue 2, August 2018, Pages 378-382
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Evidence-Based Medicine
Chronic Cough Related to Acute Viral Bronchiolitis in Children: CHEST Expert Panel Report

https://doi.org/10.1016/j.chest.2018.04.019Get rights and content

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.

Key Words

cough
evidence-based medicine
guidelines

Abbreviations

KQ
key question
RCT
randomized controlled trial

Cited by (0)

FUNDING/SUPPORT: A. B. C. is supported by an NHMRC practitioner fellowship [Grant 1058213] and holds multiple grants awarded from the NHMRC related to diseases associated with pediatric cough and acute bronchiolitis. The views expressed in this publication are those of the authors and do not reflect the views of the NHMRC.

DISCLAIMER: American College of Chest Physician guidelines are intended for general information only, are not medical advice, and do not replace professional medical care and physician advice, which always should be sought for any medical condition. The complete disclaimer for this guideline can be accessed at http://www.chestnet.org/Guidelines-and-Resources/Guidelines-and-Consensus-Statements/CHEST-Guidelines.

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