Abstract
Pulmonary hyperinflation is the dominant pathophysiological sign of CHOPN. Its influence on bronchial obstruction gets stronger on exertion due to the progress of dynamic hyperinflation associated with an increase in EEL.
An important aim of therapy in CHOPN is to reduce the hyperinflation. Apart from non-pharmacological methods solving localized forms of pulmonary hyperinflation there is also a pharmacological option by means of tiotropium (a long-term affecting inhalation parasympaticolyticum).
Evidence of a favorable effect of tiotropium led the authors of the latest recommendation related to the care of patients with CHOPN to modify the current medication scheme. Tiotropium appears to be the medicine of first choice for the II. clinical stage (according to GOLD).
The patients´ care should be complex, and in this regard it is necessary to emphasize the markedly positive influence of lung rehabilitation, especially when combined with the above mentioned inhalation treatment.