• Lorcan McGarvey, Bruce K Rubin, Satoru Ebihara, Karen Hegland, Alycia Rivet, Richard S Irwin, Donald C Bolser, Anne B Chang, Peter G Gibson, Stuart B Mazzone, and CHEST Expert Cough Panel.
• Wellcome-Wolfson Institute of Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland. Electronic address: l.mcgarvey@qub.ac.uk.
• Chest. 2021 Oct 1; 160 (4): 141314231413-1423.

BackgroundCough characteristics vary between patients, and this can impact clinical diagnosis and care. The purpose of part two 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.Study Design And MethodsA review of the literature was conducted using PubMed and MEDLINE databases from 1951 to 2019 using prespecified search terms.ResultsWe describe the demographics of typical patients with cough in the clinical setting, including how cough characteristics change across age. We summarize the effect of common clinical conditions impacting cough mechanics and the physical properties of mucus on airway clearance.InterpretationThis is the second of a two-part update to the 2006 CHEST cough guideline; it complements part one on basic phenomenology of cough by providing an extended clinical picture of cough along with the factors that alter cough mechanics and efficiency in patients. A greater understanding of the physiology and pathophysiology of cough will improve clinical management.Copyright © 2021. Published by Elsevier Inc.

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