Non-invasive sanitation of a bronchial tree with different phenotypes of chronic obstructive pulmonary disease

One of the important components of therapy of COPD is the timely evacuation of bronchial discharge, which is able to support the inflammatory response, especially during exacerbation of COPD. <b>Objective:</b> To evaluate the effect of Hypertonic saline+hyaluronic acid (Hyaneb) on local and systemic inflammation in acute exacerbations of COPD. <b>Methods:</b> The study included 61 patients with COPD, stage III-IV, risk C-D, male, 57.76 (54.11-61.42) years old. Analyzed: C-RB dynamics, dyspnea, sputum amount, average duration of exacerbation. 2 observation groups: 1st group (n=49) with bronchitis phenotype; 2nd (n = 12) emphysematous phenotype. Hyaneb was prescribed in addition to the standard therapy (5 ml twice a day through a nebulizer, 10 days). <b>Results:</b> In 90.3% of patients with a bronchitis phenotype a positive response to therapy was obtained. In the form of an increase in sputum discharge to 300 ml on the 1st day. Reduction of 4.19 (3.72-4.65) days in the duration of COPD exacerbation in comparison with emphysematous type patients. The level of C-RB in the 1st group decreased from 6.49 (6.24-6.75) to 4.86 (4.68-5.04) mg / ml (p &lt;0.05) and had significant differences from indicators of the 2nd group. After 6 months the degree of dyspnea significantly decreased in patients of the 1st group from 3.67 (3.34-3.99) to 1.88 (1.51-2.26) points (p &lt;0.05). <b>Conclusions:</b> 1. The inclusion of Hyaneb in the treatment plan for patients with a bronchitic phenotype helps to reduce the duration of COPD exacerbation. 2. Hyaneb reduces the level of inflammatory markers during exacerbation of COPD. 3. The use of Hyaneb can be considered as a non-invasive sanation bronchoscopy.