Abstract

Purpose: to develop a technique for therapeutic application of photoactivated photosensitizer «Radachlorin» to be included into the complextherapy of nosocomial pneumonia.Material and methods. Twelve patients with nosocomial pneumonia were taken in the trial. They were treated with a device having a nebulizer witha ring-shaped irradiator and diodes λ ≈ 660 nm for photoactivation of photosensitizer «Radachlorin» (manufactured by OOO «RADA-PHARMA»,Moscow, registration number LS-001868). The photosensitizer was developed according to the technical tasks provided by OOO «New SurgicalTechnologies» (Moscow, Russia). Radachlorin solution photolysis products were inhaled by the patients twice a day for 3 days in combinationwith the standard therapy when they were in ICU. Patients in the control group (n = 12) did not have any inhalations.Results and discussion. On day 3, the number of colony-forming units (CFU) of various pathogens found in swabs from the throat decreasedby 39.45 ± 3.17 % on average; C-reactive protein decreased by 42.38 ± 4.26 %; procalcitonin decreased by 51.83 ± 3.45 %, if to compareto baseline limits. At the same period in the control group, CFU in swabs increased in average by 17.28 ± 4.21 %; C-reactive protein increasedby 27.76 ± 3.52 %; procalcitonin increased by 30.15 ± 2.24 %. On day 10 in the main group, the number of CFU pathogens decreasedby 35.45 ± 3.32 %; C-reactive protein decreased by 72.15 ± 2.56 %; procalcitonin decreased by 55.56 ± 4.23 %, if to compare to baseline limits. On day 10 in the control group, CFU concentration remained elevated by 31.15 ± 2.56 %; C-reactive protein – by 65.32 ± 4.27; procalcitonin – by 30.21 ± 3.45 %, if to compare to baseline values. These findings indicate that the inflammatory process acquired a progressive form which demands switching to other curative modalities and more careful selection of antibiotics. The probability of random origin in statistical processing is p < 0.05. There were no undesirable side effects during procedures.Conclusion. Justified application of the described technique – inhalations of photolysis products of E 6 chloride derivatives – has an effective therapeutic impact at the course of nosocomial pneumonia. It seems promising to continue investigations on the described technique, namely, to search for the most effective ways of its application, to find out an optimal number and frequency of procedures under the control of general clinical and special methods of examination of the studied patients, since the data which have been obtained by the authors us are preliminary and should be supplemented with new findings.

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