BACKGROUND: The purpose of this state-of-the-art review is to update the American College of Chest Physicians (CHEST) 2006 guideline on global physiology and pathophysiology of cough.
METHODS: A review of the literature was conducted using PubMed and Medline databases from 1951 to 2019 using pre-specified search terms.
RESULTS: We describe the basic phenomenology of cough patterns, behaviors and morphologic features. We update the understanding of mechanical and physiologic characteristics of cough, adding a contemporary view of the types of cough and their associated behaviors and sensations. New information about acoustic characteristics is presented, and recent insights into cough triggers and the cough hypersensitivity patient phenotype are explored. Lastly, because the clinical assessment of patients largely focuses on the duration rather than morphologic features of cough, we review the morphological features of cough that can be measured in the clinic.
CONCLUSIONS: This is the first of a two-part update to the 2006 CHEST Cough Guideline; it provides a more global consideration of cough phenomenology, beyond simply the mechanical aspects of a cough. A greater understanding of the typical features of cough, and their variations, may allow a more informed interpretation of cough measurements and the clinical relevance for patients.