An approach to the child with a wet cough

Gilchrist, Francis J

doi:10.1016/j.prrv.2018.11.002

Cited by 10 publications

(38 citation statements)

References 53 publications

(66 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…">Recurrent lower respiratory tract infections: Multiple episodes of pneumonia‐‐especially during the first few years of life—are reported in as many as 50% of the children whereas intermittent or chronic bronchitis is reported by almost two‐third of adults with EA‐TEF 9,11,13,15‐18,40‐45 . Recurrent lower respiratory tract infections can lead to bronchiectasis, poor lung function, and lower quality of life in adulthood 39,42,46 …”

Section: Resultsmentioning

confidence: 99%

“…Exacerbations are associated with increased purulent sputum production, frequently fever, dyspnea, and in advanced cases hemoptysis 48,49 . Because young children cannot expectorate, changes in the quality of the cough from dry to “wet” have been proposed as an alternative to changes in sputum production and appearance 46,48,49 …”

Section: Resultsmentioning

confidence: 99%

“…9,11,13,[15][16][17][18][40][41][42][43][44][45] Recurrent lower respiratory tract infections can lead to bronchiectasis, poor lung function, and lower quality of life in adulthood. 39,42,46 4. Chronic or recurrent "wheezing": Infants and young children with EA-TEF often produce a wheeze-like persistent harsh expiratory noise that is often misdiagnosed as "bronchiolitis" or "asthma", or in older patients as exercise induced asthma.…”

Section: Chronic Coughmentioning

confidence: 99%

See 2 more Smart Citations

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Koumbourlis

Belessis

Cataletto

et al. 2020

Pediatric Pulmonology

View full text Add to dashboard Cite

Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition. As there are no randomized controlled studies on the subject, a group of experts used a modification of the Rand Appropriateness Method to describe the various aspects of the condition in terms of their relative importance, and to rate the available diagnostic methods and therapeutic interventions on the basis of their appropriateness and necessity. Specific recommendations were formulated and reported as Level A, B, and C based on whether they were based on “strong”, “moderate” or “weak” agreement. The tracheomalacia that exists in the site of the fistula was considered the main abnormality that predisposes to all other respiratory complications due to airway collapse and impaired clearance of secretions. Aspiration due to impaired airway protection reflexes is the main underlying contributing mechanism. Flexible bronchoscopy is the main diagnostic modality, aided by imaging modalities, especially CT scans of the chest. Noninvasive positive airway pressure support, surgical techniques such as tracheopexy and rarely tracheostomy are required for the management of severe tracheomalacia. Regular long‐term follow‐up by a multidisciplinary team was considered imperative. Specific templates outlining the elements of the clinical respiratory evaluation according to the patients’ age were also developed.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Chronic Coughmentioning

confidence: 99%

See 1 more Smart Citation

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Koumbourlis

Belessis

Cataletto

et al. 2020

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…9,11,13,[15][16][17][18][41][42][43][44][45][46] Recurrent lower respiratory tract infections can lead to bronchiectasis, poor lung function, and lower quality of life in adulthood. 40,43,47 -Chronic or recurrent "wheezing" : Infants and young children with EA-TEF often produce a wheezelike persistent harsh expiratory noise that is often misdiagnosed as "bronchiolitis" or "asthma", or in older patients as exercise induced asthma. The "wheeze" is produced by the collapse of the tracheal lumen and not by bronchospasm and therefore does not respond to bronchodilators.…”

Section: Respiratory Pathophysiologymentioning

confidence: 99%

“…Exacerbations are associated with increased purulent sputum production, frequently fever, dyspnea, and in advanced cases hemoptysis. 49,50 Because young children cannot expectorate, changes in the quality of the cough from dry to "wet" have been proposed as an alternative to changes in sputum production and appearance 47,49,50 .…”

Section: Bronchiectasismentioning

confidence: 99%

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Koumbourlis

Belessis

Cataletto

et al. 2020

Preprint

View full text Add to dashboard Cite

Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition. As there are no randomized controlled studies on the subject, a group of experts used a modification of the Rand Appropriateness Method to describe the various aspects of the condition in terms of their relative importance, and to rate the available diagnostic methods and therapeutic interventions on the basis of their appropriateness and necessity. Specific recommendations were formulated and reported as Level A, B, C based on whether they were based on "strong", "moderate" or "weak" agreement. The tracheomalacia that exists in the site of the fistula was considered the main abnormality that predisposes to all other respiratory complications due to airway collapse and impaired clearance of secretions. Aspiration due to impaired airway protection reflexes is the main underlying contributing mechanism. Flexible bronchoscopy is the main diagnostic modality, aided by imaging modalities, especially CT scans of the chest. Non-invasive positive airway pressure support, surgical techniques such as tracheopexy and rarely tracheostomy are required for the management of severe tracheomalacia. Regular long-term follow-up by a multidisciplinary team was considered imperative. Specific templates outlining the elements of the clinical respiratory evaluation according to the patients' age were also developed.

show abstract

Protocol for CLASSIC PBB: comparison of lower airway sampling strategies in children with protracted bacterial bronchitis

Gilchrist

Aspey

Bowler

et al. 2022

bmjpo

View full text Add to dashboard Cite

BackgroundProtracted bacterial bronchitis (PBB) is an endobronchial infection and a the most common cause of chronic wet cough in young children. It is treated with antibiotics, which can only be targeted if the causative organism is known. As most affected children do not expectorate sputum, lower airway samples can only be obtained by bronchoalveolar lavage (BAL) samples taken during flexible bronchoscopy (FB-BAL). This is invasive and is therefore reserved for children with severe or relapsing cases. Most children with PBB are treated empirically with broad spectrum antibiotics. CLASSIC PBB will compare the pathogen yield from two less invasive strategies with that from FB-BAL to see if they are comparable.Methods131 children with PBB from four UK centres referred FB-BAL will be recruited. When attending for FB-BAL, they will have a cough swab and an induced sputum sample obtained. The primary outcome will be the discordance of the pathogen yield from the cough swab and the induced sputum when compared with FB-BAL. Secondary outcomes will be the sensitivity of each sampling strategy, the success rate of the induced sputum in producing a usable sample and the tolerability of each of the three sampling strategies.DiscussionIf either or both of the two less invasive airway sampling strategies are shown to be a useful alternative to FB-BAL, this will lead to more children with PBB having lower airway samples enabling targeted antibiotic prescribing. It would also reduce the need for FB, which is known to be burdensome for children and their families.Trial registration numberISRCTN79883982.

show abstract

An approach to the child with a wet cough

Cited by 10 publications

References 53 publications

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Protocol for CLASSIC PBB: comparison of lower airway sampling strategies in children with protracted bacterial bronchitis

Contact Info

Product

Resources

About