Evaluation of Benefit of Nebulized Bronchodilators at Home in Severe Chronic Obstructive Pulmonary Disease and Very Severe Steady State

Inclusion Criteria: * Adult * COPD Patients stage 3 et 4 * Has not submitted an exacerbation in the 3 months preceding the pre-inclusion visit * Weaned from tobacco for at least 6 months * vaccinated against pneumococcal * Have not been included in a pulmonary rehabilitation program during the 6 months preceding the screening visit inclusion * Patient pre-included not showing exacerbation since the pre-inclusion visit Exclusion Criteria: * Patient under nebulizer or has been treated with nebulized bronchodilators at home over the last 6 months * Patient with an indication of oxygen is expected in the coming year * Progressive malignant disease known * Patient under non-invasive ventilation (NIV) for less than 6 months or NIV provided in the following year * Patient known to be colonized by Pseudomonas aeruginosa, A. xylosoxidans, Burkholderia cepacia or Stenotrophomonas maltophilia * Patients with severe cardiovascular disease * Pregnancy