Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “COUGH”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed2005

[The clinical features and the diagnosis of gastro-esophageal reflux induced cough].

OBJECTIVE: Gastro-esophageal reflux (GER) is an important etiological factor inducing chronic cough. This study aims to identify the clinical features for the diagnosis of GER induced cough (GERC). METHODS: A modified Irwin's diagnostic protocol and continuous 24-hour esophageal pH monitoring were performed in 50 patients with chronic cough. Twenty patients were diagnosed as having GERC. The clinical features were compared with those of non-GER (NGER) induced cough. RESULTS: One hundred and ninety-two patients met the chronic cough criteria and were fully evaluated. The x +/- s of age was (40.6 +/- 12.1) years (range, 10 - 69 years) and 101 were males and 91 were females, with a cough history of 25 months (range, 2 - 487 months). GER accounted for 10.4% (n = 20) of the causes and was the fourth common cause of chronic cough. The mean +/- SD of age was (37.7 +/- 13.9) years (range, 10 - 60 years) in the GERC group, with a cough history of 61 months (range, 3 - 360 months). Cough associated with having meals (occurring while eating or anytime during the subsequent 2 h) was present in 13 out of the 20 patients in GERC, significantly higher than that in NGER (2 out of 23 patients) (chi2= 14.29, P < 0.01). The specificity, the positive predictive value and the sensitivity of cough associated with meals for GERC were 91.3%, 86.7% and 65.0%, respectively. Regurgitation associated symptom was present in 11 out of the 20 patients in the GERC group, not significantly different from that in the NGER group (8 out of 23 patients). Continuous 24 hour ambulatory esophageal pH measurement showed that reflux events were more common in upright [8.9 (range, 1.9 - 71.9)%] than in supine position [1.4 (range, 0 - 41.2)%] as well as at post-meal [20.2 (range, 2.1 - 84.2)%] than during meal period [1.95 (range, 0 - 51.6)%] (P < 0.01 and P < 0.05). CONCLUSION: Cough associated with having meals is of diagnostic value for GERC. The reflux events are more frequent when patients are awake, with upright position and after meals.

Adult↗
PubMed2005

Prophylactic versus therapeutic administration of intravenous lidocaine for suppression of post-extubation cough following cataract surgery: a randomized double blind placebo controlled clinical trial.

BACKGROUND: Post-extubation cough causes considerable patient discomfort and in certain surgical procedures may lead to postoperative surgical complication. Different drugs and techniques have been used for the prevention of post-extubation cough with variable success rates. Prophylactic administration of lidocaine has been tried for the prevention of post-extubation cough with controversial results. No previous study has been performed to evaluate the therapeutic effect of intravenous lidocaine for treatment of post-extubation cough. This study was designed to compare the prophylactic effect of intravenous lidocaine with that of the therapeutic lidocaine in a sample of adult patients undergoing general anesthesia for cataract surgery. METHODS: The study was performed in two phases. In the first phase 200 adult patients were consecutively included in the study. They were randomly divided into two groups to receive either intravenous lidocaine 1 mg/kg or the same volume of normal saline as placebo prior to extubation. Proportions of patient with post-extubation cough were compared between two groups. Patients with established cough comprised the sample of the second phase of the study in which they randomly divided into two groups to receive either intravenous lidocaine 0.5 mg/kg or placebo to abort the coughs. Proportions of patients with successful response to lidocaine were compared between two groups. RESULTS: Proportions of patients with post-extubation cough were not significantly different in two prophylactic groups as revealed by 19 (20.7%) in lidocaine vs. 27 (28.7%) in placebo. The efficacy of prophylactic lidocaine for suppression of post-extubation cough was estimated to be 28.1%. Proportion of patients who were successfully treated in the second phase of the study was significantly higher in therapeutic lidocaine group 20 (80%) vs. 10 (38.5%) in placebo group (P = 0.003). CONCLUSIONS: The outcome of this study shows that prophylactic administration of lidocaine prior to tracheal extubation may be ineffective to prevent post-extubation cough. Based on the results of this study it can be recommended that post-extubation cough should be treated upon occurrence instead of routine prophylactic administration of lidocaine.

Adult↗
PubMed1980

Intrapleural cough pressure in patients after thoracotomy.

Quantitative studies of cough strength seem to be valuable in evaluating cough dynamics and the effectiveness of various procedures designed to raise the cough force. To evaluate cough strength in 20 patients after thoracotomy intrapleural cough pressures were measured with a balloon catheter inserted in the ipsilateral pleural space toward the apex. A balloon catheter designed to measure intraluminal esophageal pressure was used in this study. The balloon was inflated with 1 ml of air and the transmitted intrapleural pressure was measured during the maximum voluntary cough effort in the supine and/or sitting position. The pressure change during coughing seems to serve as an index in evaluating the strength of the respiratory muscles. It was observed that the cough pressure increased progressively following thoracotomy, and that it was higher in the sitting position than in the supine position. The most effective procedure to raise the maximum cough pressure was manually assisted compression of the chest wall in the sitting position during voluntary coughing. Epidural anesthesia following thoracotomy seemed to be effective in inducing higher cough pressure changes.

Adult↗
PubMed2005

Cough: are children really different to adults?

Worldwide paediatricians advocate that children should be managed differently from adults. In this article, similarities and differences between children and adults related to cough are presented. Physiologically, the cough pathway is closely linked to the control of breathing (the central respiratory pattern generator). As respiratory control and associated reflexes undergo a maturation process, it is expected that the cough would likewise undergo developmental stages as well. Clinically, the 'big three' causes of chronic cough in adults (asthma, post-nasal drip and gastroesophageal reflux) are far less common causes of chronic cough in children. This has been repeatedly shown by different groups in both clinical and epidemiological studies. Therapeutically, some medications used empirically for cough in adults have little role in paediatrics. For example, anti-histamines (in particular H1 antagonists) recommended as a front-line empirical treatment of chronic cough in adults have no effect in paediatric cough. Instead it is associated with adverse reactions and toxicity. Similarly, codeine and its derivatives used widely for cough in adults are not efficacious in children and are contraindicated in young children. Corticosteroids, the other front-line empirical therapy recommended for adults, are also minimally (if at all) efficacious for treating non-specific cough in children. In summary, current data support that management guidelines for paediatric cough should be different to those in adults as the aetiological factors and treatment in children significantly differ to those in adults.

Journal Article↗
PubMed2006

The description of cough sounds by healthcare professionals.

BACKGROUND: Little is known of the language healthcare professionals use to describe cough sounds. We aimed to examine how they describe cough sounds and to assess whether these descriptions suggested they appreciate the basic sound qualities (as assessed by acoustic analysis) and the underlying diagnosis of the patient coughing. METHODS: 53 health professionals from two large respiratory tertiary referral centres were recruited; 22 doctors and 31 staff from professions allied to medicine. Participants listened to 9 sequences of spontaneous cough sounds from common respiratory diseases. For each cough they selected patient gender, the most appropriate descriptors and a diagnosis. Cluster analysis was performed to assess which cough sounds attracted similar descriptions. RESULTS: Gender was correctly identified in 93% of cases. The presence or absence of mucus was correct in 76.1% and wheeze in 39.3% of cases. However, identifying clinical diagnosis from cough was poor at 34.0%. Cluster analysis showed coughs with the same acoustics properties rather than the same diagnoses attracted the same descriptions. CONCLUSION: These results suggest that healthcare professionals can recognise some of the qualities of cough sounds but are poor at making diagnoses from them. It remains to be seen whether in the future cough sound acoustics will provide useful clinical information and whether their study will lead to the development of useful new outcome measures in cough monitoring.

Journal Article↗
PubMed2006

Effect of N-arachidonoyl-(2-methyl-4-hydroxyphenyl) amine (VDM11), an anandamide transporter inhibitor, on capsaicin-induced cough in mice.

BACKGROUND: Several observations have suggested that anandamide, an endogenous cannabinoid ligand, plays an important role in the modulation of cough sensitivity. However, it is unknown whether the anandamide membrane transporter plays a role in this modulation. To test this hypothesis, we investigated the effects of VDM11, an anandamide membrane transporter inhibitor, on capsaicin- and anandamide-induced cough. METHODS: The effect of VDM11, an anandamide membrane transporter inhibitor, on capsaicin- and anandamide-induced cough in mice was examined. RESULTS: VDM11, at doses of 3-10 mg/kg subcutaneously, produced a dose-dependent antitussive effect. This antitussive effect was antagonized by pretreatment with either intraperitoneal administration (3 mg/kg) or inhalation (1 mg/ml) of SR141716A, a cannabinoid receptor (CB1) antagonist. However, intracerebroventricular injection of SR141716A (0.03 mg/mouse) did not alter the effect of VDM11. Exposure of mice to a nebulized solution of 10% DMSO, a vehicle of anandamide, induced a cough response (7.7 +/- 0.6 coughs/3 min; n = 10). Exposure of mice to a nebulized solution of anandamide, at concentrations of 0.03, 0.3 and 3 mg/ml, also produced a cough response in a concentration-dependent manner. The number of coughs induced by low dose (0.03 mg/ml) anandamide was significantly less than that of 10% DMSO. On the other hand, the number of coughs induced by high dose (3 mg/ml) anandamide was significantly greater than that of 10% DMSO. When AM251 (1.8 mM), a selective CB1 receptor antagonist, was given by aerosol for 4 min before inhalation of 0.03 mg/ml of anandamide, the number of coughs was significantly increased to the level observed with 10% DMSO alone. When capsazepine (0.3 mM), a selective TRPV1 receptor antagonist, was given via aerosol for 4 min before inhalation of 3 mg/ml of anandamide, the number of coughs was significantly decreased to the levels observed with 10% DMSO alone. The number of coughs induced by high dose (3 mg/ml) anandamide was significantly and dose-dependently reduced by the pretreatment with VDM11. CONCLUSION: These results suggest that anandamide, an endogenous cannabinoid ligand, may modulate cough sensitivity and that anandamide transporters play an important role in this modulation. Furthermore, these findings indicate that inhibition of the uptake of anandamide produced a potent antitussive effect and suggests that the anandamide transporter may be a potential target for peripherally acting antitussive drugs.

Journal Article↗
PubMed2006

Prevalence of psychomorbidity among patients with chronic cough.

BACKGROUND: Chronic cough may cause significant emotional distress and although patients are not routinely assessed for co-existent psychomorbidity, a cough that is refractory to any treatment is sometimes suspected to be functional in origin. It is not known if patients with chronic cough referred for specialist evaluation have emotional impairment but failure to recognise this may influence treatment outcomes. In this cross-sectional study, levels of psychomorbidity were measured in patients referred to a specialist cough clinic. METHODS: Fifty-seven patients (40 female), mean age 47.5 (14.3) years referred for specialist evaluation of chronic cough (mean cough duration 69.2 (78.5) months) completed the Hospital Anxiety and Depression (HAD) scale, State Trait Anxiety Inventory (STAI) and the Crown Crisp Experiential Index (CCEI) at initial clinic presentation. Subjects then underwent a comprehensive diagnostic evaluation, after which they were classified as either treated cough (TC) or idiopathic cough (IC). Questionnaire scores were compared between TC (n = 42) and IC (n = 15). RESULTS: Using the HAD scale, 33% of all cough patients were identified as anxious, while 16% experienced depression. The STAI scores suggested moderate or high trait anxiety in 48% of all coughers. Trait anxiety was significantly higher among TC (p < 0.001) and IC patients (p = 0.004) compared to a healthy adult population. On the CCEI, mean scores on the phobic anxiety, somatisation, depression, and obsession subscales were significantly higher among all cough patients than the published mean scores for healthy controls. Only state anxiety was significantly higher in IC patients compared with TC patients (p < 0.05). CONCLUSION: Patients with chronic cough appear to have increased levels of emotional upset although psychological questionnaires do not readily distinguish between idiopathic coughers and those successfully treated.

Journal Article↗
PubMed2005

Antibiotics for prolonged moist cough in children.

BACKGROUND: Cough is the most common symptom which presents to doctors. Chronic cough is reported in up to 9% of preschool aged children. American general practice guidelines suggest antimicrobial treatment may be indicated in children with cough lasting > 10 days. Questions concerning the benefits and harm of antibiotic treatment for prolonged cough in children need to be resolved. OBJECTIVES: A Cochrane systematic review was undertaken to determine the efficacy of antibiotics in treating children with chronic moist cough (excluding those with bronchiectasis or other underlying respiratory illnesses). SEARCH STRATEGY: The Cochrane Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE, EMBASE, review articles and reference lists of relevant articles were searched. The latest searches were performed on 12th April 2004. SELECTION CRITERIA: All randomised controlled trials (RCTs) comparing antibiotics with a placebo or a control group in children with chronic moist cough were considered. DATA COLLECTION AND ANALYSIS: Results of searches were reviewed against pre-determined criteria for inclusion. Two independent reviewers selected, extracted and assessed the data for inclusion. Authors were contacted for further information. Data were analysed as 'intention to treat'. MAIN RESULTS: Two studies were eligible for inclusion in the review. Neither study was high quality. Both studies failed to include a prospective analysis of cough quality in their inclusion criteria, although indicating >75% of children included had moist cough (Darelid 1993). A total of 140 patients, aged seven years or less, were included in meta-analysis. Treatment with antibiotics reduced the proportion of children not cured at follow-up (primary outcome measure) in both studies; pooled odds ratio (OR) was 0.13, 95% CI 0.06 to 0.32 (using intention to treat analysis), which translates to number needed to treat (NNT) of 3 (95% CI 2 to 4). No significant heterogeneity was found (fixed and random-effects model I(2) was 4%). However for this outcome measure, the overall estimate of effect and degree of statistical heterogeneity were sensitive to the model used for meta-analysis. Progression of illness, defined by requirement for further antibiotics, was significantly lower in the treatment group (OR 0.10, 95%CI 0.03 to 0.34), NNT was 4 (95% CI 3 to 5). Adverse events were not significantly increased in the treatment group. AUTHORS' CONCLUSIONS: Antibiotics are likely to be beneficial in the treatment of children with chronic moist cough. This evidence is however limited by study quality, study design and sensitivity analysis data. The use of antibiotics however has to be balanced against their well known adverse events. Further well-designed RCTs using valid cough outcome measures are needed to answer this question conclusively.

Anti-Bacterial Agents↗
PubMed1989

Cough-cardiopulmonary resuscitation in the cardiac catheterization laboratory: hemodynamics during an episode of prolonged hypotensive ventricular tachycardia.

Cough-CPR, a deep rhythmic forceful cough repeated 30-60 times per minute, can be an effective resuscitative technique during emergencies occurring in the cardiac catheterization laboratory. We provide documented evidence on the potential of cough-CPR to maintain adequate systemic arterial blood pressure and consciousness during malignant ventricular arrhythmias, including the longest cough-CPR episode (75-90 sec), with continuous hemodynamics recorded. Results in three patients disclose that 1) mean arterial pressure during cough-CPR was 47-66% of nonarrhythmic baseline at a cough rate of 38-46% of normal sinus rhythm heart rate; 2) mean arterial pressure during hypotensive ventricular tachycardia was 17-60 mm Hg higher with than without cough-CPR; 3) at comparable diastolic pressures (33 vs. 31 mm Hg), systolic arterial pressure during cough-CPR was 40 mm Hg higher than basic CPR; and 4) consciousness can be maintained with cough-CPR during prolonged malignant ventricular arrhythmias. Thus cough-CPR can be a valuable adjunct in maintaining patient stability while definitive therapy for the malignant ventricular arrhythmia is administered.

Aged↗
PubMedDate not supplied

Analysis of the cough sound: an overview.

Coughing is presented by a sudden air expulsion from the airways which is characterized by a typical sound. This sound is so characteristic that it allows identification of the cough and its distinction from other vocal manifestations. The cough sound is a very important symptom of well over 100 diseases and other conditions of medical significance. Changes in its character may have a considerable value in identifying the mechanisms of airway pathology present in respiratory diseases. The cough sound gives information about the pathophysiological mechanisms of coughing by indicating the structural nature of the tissue during therapy that leads to certain patterns of cough. Similarly the character of the cough sound gives information about the behaviour of the glottis and whether the glottis behaves differently in different pathological conditions. Analysis of the cough sound record has significant value in prognosis because its changes may indicate the effectiveness of therapy or the progress of disease. Despite recent progress in cough sound research the attention paid to this interesting physiological and clinical problem is still not sufficient to solve completely various open questions, including our correct knowledge of the mechanism of creation of cough sounds.

Cough↗
PubMedDate not supplied

Codeine, cough and upper respiratory infection.

Codeine is generally accepted as a standard or reference antitussive against which new antitussive medications can be compared. However there are very few studies which have investigated the antitussive efficacy of codeine using cough associated with upper respiratory tract infection (URTI) and there is little if any evidence to support the antitussive efficacy of codeine in this model. This paper discusses the mechanism of cough in man and describes some clinical investigations on the effects of codeine on cough associated with URTI. The recent clinical investigations do not provide any evidence to support an antitussive action of codeine in the treatment of cough associated with URTI yet there is evidence in the literature which indicates that codeine inhibits fictive cough in animal models and also has antitussive activity against both induced and chronic cough models in man. In order to explain these different effects of codeine on the different models of cough, a hypothesis is put forward that there are two cough pathways in man. A voluntary pathway associated with cough related to URTI which is not affected by codeine, and a reflex pathway associated with induced and chronic cough which is inhibited by codeine.

Acute Disease↗
PubMed2001

Effects of inhaled corticosteroids on cough threshold in patients with bronchial asthma.

In asthmatic subjects cough can be related to the degree of airway inflammation. The aim of this study was to evaluate the effect of treatment with high dose inhaled beclomethasone dipropionate (BDP) on cough threshold in asthmatic subjects. Cough threshold to inhaled capsaicin (one breath of 10(-8)-10(-4)M solution) and to citric acid (one breath of 10(-4)-1 M), expressed as provocative concentration of two (PC2) and four coughs (PC4), was measured in 16 normal and 36 asthmatic subjects. After baseline evaluation, asthmatic subjects were randomized in two groups: (a) Group A, n=20: treated with salbutamol (200 microg t.i.d.) plus BDP (500 microg t.i.d.); (b) Group B, n=16: treated with salbutamol plus placebo in the same doses. After 1 month, cough threshold and clinical and functional evaluation were repeated. After treatment, asthmatics of group A showed a significant improvement in PC4 citric acid, in total symptom and cough scores, and in PD20FEV1 methacholine. In asthmatics of group B, treatment caused no improvement in symptoms, PD20FEV1 methacoline and cough threshold. In addition, cough threshold was not different between normal and asthmatic subjects and, in asthmatics, cough threshold did not correlate with PD20FEV1 methacholine. These data confirm that cough in asthma can be partially related to airway inflammation.

Administration, Inhalation↗
PubMed2002

Epidemiology of cough.

Patients with cough may be conveniently divided into those with acute, usually viral, illness and those with chronic cough. Acute cough represents the largest single cause of consultation in primary care, whereas chronic cough is one of the commonest presentations in respiratory medicine. The world-wide market in cough treatments is several billion dollars. In both syndromes, cough sensitivity is upregulated, but the inflammation giving rise to cough is localised to the larynx and large airways in acute cough. Whilst this is also true of cough-predominant asthma, the origin of cough in chronic disease may also lie in the oesophagus, nose or sinuses leading to errors in diagnosis and treatment.

Acute Disease↗
PubMed2002

Assessment and measurement of cough: the value of new tools.

On systematic investigation, patients with persistent cough are often diagnosed as having asthma, gastro-oesophageal reflux (GOR) and post-nasal drip; often, there is no associated diagnosis. Cough-variant asthma and eosinophilic bronchitis are conditions presenting with cough, usually associated with airway eosinophilia and responding well to corticosteroids. These conditions including asthma are best grouped as 'eosinophil-associated cough'. Analysis of induced sputum for eosinophils is an important tool in the investigation of chronic persistent cough. Reliable ambulatory counters for cough have been developed and the contribution of cough count and intensity to the severity of cough have been partly evaluated, and used in assessing antitussive therapies. Self-scoring evaluations are still widely used, but the inclusion of quality of life tools specifically adapted to the evaluation of cough appears to be a useful tool that can directly measure the impact of chronic cough. We need a greater assessment and evaluation of all these tools.

Bronchitis↗
PubMed1995

Chronic night cough and asthma severity in children with stable asthma.

The relationship between night cough and other indices of asthma severity was studied in 21 children with clinically stable asthma and persistent night cough. Overnight cough was quantified and related to symptom scores, oxygen saturation (SaO2) during sleep, evening and morning peak flow recordings and daytime tests of lung function. In the index group the median number of coughing episodes was 23 (range 1-158). Only 4 children had counts of < 10 overnight, similar to the comparison group of 12 children all of whom had counts of < 10. There was a trend towards the association of overnight cough with reduced evening peak flow (r = -0.407, P = 0.07) and reduced SaO2 (r = -0.36, P = 0.10). Abnormalities in daytime tests of lung function were observed in 13 children. There was no relationship between night cough and daytime indices of lung function abnormality although children with more severe daytime abnormalities also had significant night cough. Conversely, five children with chronic night cough had normal daytime function. Conclusion. Night-time cough in children with asthma is not simply a reflection of daytime lung function status, whereas, overnight SaO2 correlates well. Other factors need to be explored to explain the variability of night-time cough in these children.

Adolescent↗
PubMed2004

Effect of inhaled corticosteroids on symptom severity and sputum mediator levels in chronic persistent cough.

BACKGROUND: Chronic cough often lasts for more than 1 year and is associated with airway inflammation. The effect of inhaled corticosteroids on symptom severity and inflammatory mediator levels in these patients is unknown. OBJECTIVE: We sought to determine whether inhaled corticosteroids reduce cough severity and sputum mediator concentrations in patients with chronic persistent cough. METHODS: We performed a double-blind, randomized, placebo-controlled crossover study with inhaled fluticasone, 500 microg twice daily, and placebo for 14 days in 88 patients with cough for more than 1 year, with normal chest radiography and spirometry results. Outcome measures were a daily cough visual analogue scale and induced sputum concentrations of eosinophilic cationic protein (ECP), myeloperoxidase, leukotriene B(4) (LTB(4)), leukotrienes C(4)/D(4)/E(4) (cysteinyl leukotrienes [Cys-LTs]), prostaglandin E(2) (PGE(2)), IL-8, and TNF-alpha. Sputum cell counts, exhaled nitric oxide levels, and carbon monoxide levels were also measured. RESULTS: There was a significant improvement in the cough visual analogue scale after inhaled fluticasone compared with placebo (mean difference, 1.0; 95% CI, 0.4-1.5; P <.001). LTB(4), Cys-LT, and PGE(2) levels were increased in all causes of cough. Sputum ECP counts, exhaled nitric oxide levels, and carbon monoxide levels decreased significantly after inhaled fluticasone. There was no change in sputum cell counts and other mediator concentrations. CONCLUSION: Cough severity and sputum ECP levels are modestly reduced by inhaled corticosteroids in patients with chronic cough persisting for more than 1 year. LTB(4), Cys-LT, PGE(2), IL-8, myeloperoxidase, and TNF-alpha levels are unaltered by this therapy. This raises the possibility that drugs targeted to reduce the effects of these mediators might be of benefit in chronic persistent cough.

Administration, Inhalation↗
PubMed2006

Investigation and management of suppurative cough in pre-school children.

Suppurative cough can be defined as a cough where purulent sputum is produced. Chronic suppurative cough may be associated with the destruction of the bronchial wall (bronchiectasis). As mild forms of the disease are not associated with respiratory limitation or failure to thrive, such children may not present for investigation and therefore the true incidence of suppurative cough is difficult to gauge. Chronic suppurative cough remains an important health problem in developing countries and some indigenous populations of developed countries. The purpose of this review is to present the appropriate investigations and evaluate the evidence for current management strategies in children with suppurative cough. To accomplish this, a brief discussion on the aetiology of suppurative cough in childhood is presented. The most commonly identifiable cause of suppurative cough is cystic fibrosis. A detailed discussion on cystic fibrosis is beyond the scope of this review. Other causes of chronic suppurative cough in pre-school children may be classified according to congenital malformations of the airway, immunodeficiency, ciliary dysfunction and, unusually, acquired causes. Microbiology of sputum culture or bronchoalveolar lavage, assessment of immune function, the role of exhaled nitric oxide and ciliary studies, and medical imaging are discussed in detail. One can conclude that the evidence for management strategies for children with suppurative cough is, at best, level 3 evidence, i.e. non-randomised, controlled or cohort studies.

Child, Preschool↗
PubMed2006

The physiology of cough.

Cough is comprised of three phases (inspiratory, compressive and expiratory) and serves as a vital defensive mechanism for lung health. It prevents pulmonary aspiration, promotes ciliary activity and clears airway debris. The importance of an intact cough mechanism is reflected in the occurrence of pulmonary problems when cough is inefficient. Cough efficiency is dependent on physical/mechanical aspects (respiratory muscles, mucus, airway calibre and larynx) and integrity of the neurophysiological pathway of cough. The understanding of the latter has progressed significantly (albeit mostly in animals) with the discovery of vanniloid receptors (and subtypes) and, more recently, by the characterisation of distinct cough receptors. However, the relative contributions of previously described airway afferents/receptors to cough are still disputed. Plasticity of the peripheral and central afferent pathways in cough has recently been shown to be important in pathological states associated with increased cough. To date, little is known of the developmental aspects of cough.

Cough↗