Nebulized Heparin and Salbutamol Versus Salbutamol alone in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

An acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a clinical diagnosis made when a patient with chronic obstructive pulmonary disease (COPD) experiences a sustained (e.g., 24–48 h) increase in cough, sputum production, and/or dyspnea. This study aimed to evaluate the role of nebulized heparin and salbutamol versus salbutamol alone in acute exacerbations of COPD. Methods: This double-blind and randomized controlled comparative trial included 60 patients aged 18 years or older who had either stable COPD or were experiencing AECOPD. Patients were randomly divided into two equal groups: Group A (n=30): patients with COPD exacerbation received salbutamol only. Group B (n= 30): patients with COPD exacerbation received salbutamol and heparin. Results: Non-invasive ventilation (NIV), duration of NIV and vasopressor were statistically significantly higher in Group B than Group A (P value<0.05). Conclusion: The combination of nebulized salbutamol and heparin significantly impacts clinical outcomes in patients with acute exacerbation of COPD compared to salbutamol alone. Over the treatment period, patients receiving the combined therapy demonstrated greater reductions in inflammatory markers, including total leukocyte count, C-reactive protein, and erythrocyte sedimentation rate, erythrocyte sedimentation rate, along with distinct computed tomography chest findings and a higher need for non-invasive ventilation and vasopressor support. These results suggest that while nebulized heparin may enhance the anti-inflammatory effects of standard bronchodilator therapy, its use may also be associated with more severe disease presentations requiring closer monitoring and supportive care.