Combined inhalations of xenon with photosensitizer photolysis products in complex treatment of antibiotic-resistant pneumonia

Pneumonia caused by multidrug-resistant (MDR) hospital-acquired pathogens remains one of the most serious complications in intensive care for polytrauma. High mortality and limited options for antibiotic therapy necessitate searching for adjuvant treatment approaches. We report a combined therapy with xenon inhalations and chlorin photosensitizer «Radachlorin» in a 22-year-old male with severe blast trauma complicated by bilateral MDR pneumonia. At admission, the patient demonstrated severe systemic inflammation (CRP 90.9 mg/L, PCT 12.9 ng/mL) and multiple organ dysfunction with necessary mechanical ventilation. Bronchoscopy and chest CT revealed bilateral pneumonia, while bronchoalveolar lavage revealed massive growth of Acinetobacter baumannii (107 CFU/mL, carbapenem-resistant). A course of combined therapy was performed: daily short xenon-oxygen inhalations and nebulized Radachlorin inhalations with photoactivation. Treatment resulted in significant improvement: CRP decreased to 30.2 mg/L, PCT to 0.26 ng/mL, bacterial load in airways decreased, and oxygen saturation improved to 92%. After 9-day ventilation, the patient was extubated; septic process was controlled. This case demonstrates potential of xenon inhalation with nebulized Radachlorin inhalations with photoactivation as an adjuvant modality in management of severe infectious complications in patients with polytrauma.