Leitlinie der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin zur Diagnostik und Therapie von erwachsenen Patienten mit akutem und chronischem Husten

Inhaltsverzeichnis 1 Struktur der Leitlinie 337 Präambel 1.1 Schema der Leitlinienentwicklung 3371.2 Klinische Evidenz der Leitlinie 3381.3 Klinische Algorithmen 3381.4 Veröffentlichung, Verbreitung und Aktualisierung der Leitlinie 3381.5 Sponsoring 3391.6 Potenzielle Interessenkonflikte 339 2 Epidemiologie des Hustens339 3 Anmerkungen zur Physiologie des Hustens 339 3.1 Husten auslösende Stimuli 3393.2 Hustenreflex 3393.3 Husten und Bronchospasmus 3403.4 Produktiver und nichtproduktiver Husten 3403.5 Charakteristika des Auswurfs 340 4 Ursachen und Klassifizierung des Hustens 341 5 Der akute Husten: Die wichtigsten Krankheitsbilder 342 5.1 Akute Infektionserkrankungen im Bereich der oberen und unteren Atemwege3425.2 Allergische Erkrankungen im Bereich der oberen Atemwege3435.3 Asthma 3435.4 Aspiration 3435.5 Akute inhalative Intoxikationen (Unfälle am Arbeitsplatz, Brände, Schnüffeln von Lösemitteln)3435.6 Postinfektiöser Husten 3435.7 Pneumonie 3445.8 Pleuritis 3445.9 Lungenembolie 3445.10 Pneumothorax 3445.11 Akute kardiale Erkrankungen 344 6 Der chronische Husten344 6.1 Chronische Bronchitis und COPD 3446.1.1 Chronische (nicht obstruktive) Bronchitis3446.1.2 COPD3456.2 Asthma bronchiale und weitere eosinophile Erkrankungen 3456.2.1 Asthma 3456.2.2 Husten als Asthmaäquivalent 3456.2.3 Eosinophile Bronchitis 3456.3 Lungentumoren 3466.4 Erkrankungen der oberen Atemwege 3466.4.1 Chronische Erkrankungen von Nase und Nebenhöhlen 3476.4.2 Chronische Erkrankungen von Pharynx und Larynx 3476.4.3 Chronische Ohraffektionen 3476.4.4 VCD (vocal cord dysfunction), Pseudoasthma3486.5 Gastroösophagealer Reflux (GÖR)3486.6 Husten infolge medikamentöser Therapie 3506.7 Infektionen 3506.7.1 Keuchhusten 3506.7.2 Tuberkulose 3506.8 Kardiale Ursachen für den chronischen Husten 3516.9 DLPE (Diffuse Lungenparenchymerkrankungen) – Systemerkrankungen mit Lungenparenchymbeteiligung3516.10 Husten infolge inhalativer Ereignisse 3516.10.1 Aspiration 3516.10.2 RADS (reactive airways dysfunction syndrome)3526.11 Bronchiektasen und Bronchomalazie 3526.11.1 Bronchiektasen 3526.11.2 Tracheo-Bronchomalazie 3526.12 Seltene isolierte Erkrankungen des Tracheobronchialsystems 3536.12.1 Tracheo-Bronchomegalie (M. Mounier-Kuhn) 3536.12.2 Tracheobronchiale Amyloidose 3536.12.3 Rezidivierende Polychondritis 3536.12.4 Tracheobronchopathia osteoplastica 3536.12.5 Juvenile laryngotracheale Papillomatose 3536.13 Zystische Fibrose 3536.14 Husten als Folge eines obstruktiven Schlafapnoesyndrom 3536.15 Psychogener Husten 3536.16 Chronischer idiopathischer Husten 354 7 Diagnostik 355 7.1 Akuter Husten 3557.2 Chronischer Husten 3557.3 Ambulante und stationäre Diagnostik 3587.4 Nebenwirkungen, Komplikationen und Kosten der Diagnostik 358 8 Häufige Fehler bei der Stufendiagnostik des Hustens xx 9 Therapie xx 9.1 Atemphysiotherapie xx9.1.1 Atemphysiotherapie bei produktivem Husten xx9.1.2 Atemphysiotherapie bei unproduktivem Husten xx9.1.3 Atemphysiotherapie unter Zuhilfenahme von Geräten xx9.2 Medikamentöse Therapie xx9.2.1 Hustentherapeutika mit Wirkung am Hustenrezeptor xx9.2.1.1 Expektorantien xx9.2.1.2 Medikamente, die die Schleimproduktion verringern xx9.2.1.3 Medikamente zur Steigerung der mukoziliären Clearance xx9.2.1.4 Medikamente zur Reduktion der Reizung der Hustenrezeptoren xx9.2.1.5 Schleimhautabschwellende Substanzen xx9.2.1.6 Antibiotika xx9.2.1.7 Entzündungshemmende Substanzen xx9.2.2 Hustentherapeutika mit vorwiegender Wirkung am Reflexbogen (Lokalanästhetika)xx9.2.3 Zentral wirkende Hustentherapeutika (Antitussiva)xx9.2.4 Hustentherapeutika mit Wirkung am Effektororgan xx 10 Komplikationen des Hustens xx Anhang 1 Teilnehmerliste der Konsensustreffen xx Anhang 2 Ableitung von Qualitätsindikatoren aus der Leitlinie Husten xx Anhang 3 Zusammenfassung der Leitlinie xx Anhang 4 Glossar Abkürzungen xx Literaturverzeichnis xx

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