Affiliation:
1. Pirogov Russian National Research Medical University
2. St Petersburg State Pediatric Medical University
Abstract
Bronchopulmonary diseases are an urgent problem for practical health care, as they are a frequent complication of acute respiratory viral infections (ARVI), which have a very high incidence in all age groups of the population, and especially among children. The novel coronavirus infection (COVID-19) pandemic, which the world faced in 2019, convincingly confirmed these facts. Therefore, effective pathophysiological treatment of patients with bronchopulmonary diseases is the most important task of modern pharmacotherapy. The 2 most important highly effective mechanisms for protecting the respiratory tract from pathogenic agents that provide the drainage function of the respiratory tract are described: mucociliary transport and cough. When pathological processes occur in the tracheobronchial tree (various bronchopulmonary diseases), the rheological properties of the bronchial secretion, structural and functional characteristics of the mucous membrane and submucosal layer of the airways change. This leads to mucostasis, a violation in the system of mucociliary transport – a key mechanism for protecting the respiratory tract from pathogenic agents, which significantly complicates the course and treatment of bronchopulmonary diseases, because mucostasis contributes to the violation of bronchial patency and the occurrence of atelectasis. Multfactorial is a distinctive feature of changes in mucociliary transport in bronchopulmonary diseases and requires a complex pharmacological action aimed at its normalization. Therefore, pathogenetic therapy aimed at restoring all the key factors of mucociliary transport is targeted in the treatment of various bronchopulmonary diseases. Mucoactive drugs that belong to different pharmacological groups, the use of which is aimed at restoring mucociliary transport, are considered. The necessity of using combined mucoactive drugs for the treatment of patients with bronchopulmonary diseases has been substantiated.
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