Revisión semiologica respiratoria Tos: acercamiento a la fisiopatología, enfoque y tratamiento

Review respiratory semiology. Cough approach to the pathophysiology, diagnosis and treatment

Contenido principal del artículo

Julián Cortés
Oscar Sáenz
Camilo Manrique
Francisco Gonzales
Nicolás Rocha
Rafael Miranda


La tos es uno de los síntomas respiratorios más amplios y comunes dentro de la consulta médica, encontrándose, en la práctica clínica diaria, grandes dificultades para un adecuado abordaje diagnóstico, clasificación y tratamiento. Puede ser subestimada en la mayoría de los casos, por lo que se hace prioritaria la revisión de este síntoma, abarcando fisiopatología, orientación diagnóstica y aproximación terapéutica.

Palabras clave:


Los datos de descargas todavía no están disponibles.

Detalles del artículo

Biografía del autor/a (VER)

Oscar Sáenz, Internista Neumologo. Cordinador servicio urgencias Hospital Santa Clara. Bogotá, Colombia.

Internista Neumologo. Cordinador servicio urgencias Hospital Santa Clara. Cordinador servicio medicna interna, Saludccop EPS, docente facultad de Medicina Universidad el Bosque. Bogotá, Colombia.

Camilo Manrique, Médico Internista. Coordinador Servicio urgencias Hospital Santa Clara. Bogotá, Colombia.

Médico Internista. Coordinador Servicio urgencias Hospital Santa Clara. Docente facultad de Medicina Universidad el Bosque. Bogotá, Colombia.

Francisco Gonzales, Farmacólogo. Bioeticista. Servicio urgencias Hospital Santa Clara. Bogotá, Colombia.

Farmacólogo. Bioeticista. Servicio urgencias Hospital Santa Clara. Docente facultad de Medicina Universidad el Bosque. Bogotá, Colombia.

Nicolás Rocha, Médico Internista. Fellow I Gastoenterologia Fundacion Universitaria Sanitas. Bogotá, Colombia.

Médico Internista. Servicio urgencias Hospital Santa Clara. Fellow I Gastoenterologia Fundacion Universitaria Sanitas. Bogotá, Colombia.

Referencias (VER)

Irwin RS, Boulet LP, Cloutier MM, et al. Managing cough as a defense mechanism and as a symptom: a consensus panel report of the American College of Chest Physicians. Chest 1998; 114 (suppl): 133S-181S.

French CL, Irwin RS, Curley FJ, Krikorian CJ. The impact of chronic cough on quality of life. Arch Intern Med 1998; 158: 1657-61.

Kasper DL, Eugene B, Anthony SF, et al. Principles of Internal Medicine, Capitulo 30. 16th Edition Harrisons. 2005. p. 20-207.

Fishman A, Elias JA, Fishman J, et al. Fishmans Pulmonary diseases and disorders. Cuarta edición, Capítulo 25: 1980. p. 405-409.

Anne BCh. Cough. Pediatr Clin N Am. 2009; 59: 19 – 31.

Oldenburg FA, Dolovich MB, Montgomery JM, et al. Effects of postural drainage, exercise and cough on mucus clearance in chronic bronchitis. Am Rev Respir Dis 1979; 120: 739-45.

Chang AB. State of the art: cough, cough receptors, and asthma in children. Pediatr Pulmonol 1999; 28: 59-70.

Deep V, Singh M, Ravi K. Role of vagal afferents in the reflex effects of capsaicin and lobeline in monkeys. Respir Physiol 2001; 125: 155-68.

Widdicombe JG. Afferent receptors in the airways and cough. Respir Physiol 1998; 114: 5-15.

Ho CY, Gu Q, Lin YS, et al. Sensitivity of vagal afferent endings to chemical irritants in the rat lung. Respir Physiol 2001; 127: 113-24.

McAlexander MA, Myers AC, Undem BJ. Adaptation ofguinea-pig vagal airway afferent neurones to mechanical stimulation. J Physiol 1999; 521: 239-47.

Canning BJ, Reynolds SM, Mazzone SB. Multiple mecha- nisms of reflex bronchospasm in guinea pigs. J Appl Physiol 2001; 91: 2642-53.

Matsumoto S. The activities of lung stretch and irritant receptors during cough. Neurosci Lett 1988; 90: 125-9.

Lee LY, Pisarri TE. Afferent properties and reflex functions of bronchopulmonary C-fibers. Respir Physiol 2001; 125: 47-65.

Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science 2000; 288: 1765-9.

Gu Q, Lee LY. Epinephrine enhances chemical stimulation evoked calcium transients in cultured rat vagal sensory neurons. Am J Respir Crit Care Med 2003; 167: A150.

Coleridge JC, Coleridge HM. Afferent vagal C fibre innervations of the lungs and airways and its functional significance. Rev Physiol Biochem Pharmacol 1984; 99: 1-110.

Brendan J. Canning. Reflex Anatomy and Neurophysiology of the Cough. Chest 2006; 129: 33S-47S.

McAlexander MA, Undem BJ. Potassium channel blockade induces action potential generation in guinea-pig airway vagal afferent neurones. J Auton Nerv Syst 2000; 78: 158-64.

Laude EA, Higgins KS, Morice AH. A comparative study of the effects of citric acid, capsaicin and resiniferatoxin on the cough challenge in guinea-pig and man. Pulm Pharmacol 1993; 6: 171-5

Morice AH, Geppetti P. Cough · 5: The type 1 vanilloid receptor: a sensory receptor for cough. Thorax 2004; 59: 257-8.

McCool DF. Global Physiology and Pathophysiology of cough. Chest 2006; 129: 48S-53S.

Irwin RS, Madison M. The Diagnosis and Treatment of Cough. NEJM 2000; 343: 1715-21.

Pratter MR. Cough and Common Cold. Chest 2006; 129: 72S-74S.

Curley FJ, Irwin RS, Pratter MR, et al. Cough and the common cold. Am Rev Respir Dis 1988; 138: 305-11.

Sydney S. Braman. Postinfectious Cough. Chest 2006; 129: 138S-146S.

Mello CJ, Irwin RS, Curley FJ. Predictive values of the character, timing, and complications of chronic cough in diagnosing its cause. Arch Intern Med 1996; 156: 997-1003.

Pratter MR. Overview of Common Causes of Chronic Cough. Chest 2006; 129: 59S-62S.

Irwin RS, Corrao WM, Pratter MR. Chronic persistent cough in the adult: the spectrum and frequency of causes and successful outcome of specific therapy. Am Rev Respir Dis 1981; 123: 413-7.

Palombini BC, Villanova CA, Araujo E, et al. A pathogenic triad in chronic cough: asthma, postnasal drip syndrome, and gastroesophageal reflux disease. Chest 1999; 116: 279-284

Smyrnios NA, Irwin RS, Curley FJ. Chronic cough with a history of excessive sputum production: the spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Chest 1995; 108: 991-7.

Ayik SO, Basoglu OK, Erdinc M, et al. Eosinophilic bronchitis as a cause of chronic cough. Respir Med 2003; 97: 695-701.

Puolijoki H, Lahdensuo A. Causes of prolonged cough in patients referred to a chest clinic. Ann Med 1989; 21: 425-7.

Pratter MR. Chronic Upper Cough Syndrome Secondary a Rhinosinus Diseases (Previously Referred to as Post nasal Drip Syndrome) Chest 2006: 129; 63S-71 S.

Richard S. Irwin. Complications of Cough. Chest 2006; 129: 54S-58S.

Hay DWP, Giardina GAM, Griswold DE, et al. Nonpeptide tachykinin receptor antagonists. III. SB 235375, a low central nervous system-penetrant, potent and selective neurokinin 3 receptor antagonist, inhibits citric acidinduced cough and airways hyper-reactivity in guinea-pigs. J Pharmacol Exp Ther 2002; 300: 314-23.

Belvisi M. and Geppeti P. Cough 7. Current and Future drugs for the treatment of chronic cough. Thorax 2004; 59: 438-40

Citado por