A case of xenon inhalation therapy for respiratory failure and neuropsychiatric disorders associated with COVID-19

Abstract

Acute respiratory distress syndrome (ARDS) is the main danger to the life of patients with pneumonia caused by SARS-CoV-2. At the same time, respiratory failure (RF) after ARDS can persist for a long time despite intensive therapy. Therefore, it is important to develop new effective approaches for restoring the ventilation function of the lungs after COVID-19. Here, we present a case report of effective application of short-term inhalations of xenon-oxygen (Xe/O 2 ) gas mixture for treatment of RF and neuropsychiatric disorders (NPD) associated with COVID-19. The patient inhaled a gas mixture of 70 % Xe and 30 % O 2 . We used multispiral computed tomography, evaluated psychometry, studied hematological and biochemical blood parameters, and applied some other methods of clinical studies to assess the therapeutic effectiveness of Xe inhalation. Also, we studied the mechanism of action of xenon with computer modeling. The clinical case showed the high efficacy of Xe/O 2 mixture for treating severe RF and NPD after SARS-CoV-2 infection. Xenon inhalations dramatically increased oxygen saturation and the degree of pneumatization of the lungs. We found out that in coronavirus pneumonia, saturated phospholipids of surfactant are transferred to the solid-ordered phase, which disrupts the surface tension of the alveoli and alveolar gas exchange. Using molecular modeling methods, we demonstrated that the xenon atom increases the distance between the acyl chains of phospholipids due to the van der Waals dispersion interaction. These changes allow for the phase transition of phospholipids from the solid-ordered phase to the liquid phase and restore the functional activity of the surfactant. The findings suggest the feasibility of conducting studies on the effectiveness of Xe/O 2 inhalations for treating ARDS in SARS-CoV-2 infection.

Xenon-Induced Effects in Relieving Experimental Acute Respiratory Distress Syndrome

“…ARDS damages the pulmonary surfactant system that ensures optimal gas exchange and prevents alveolar atelectasis due to low surface tension [5,6]. The effectiveness of inert gases, namely helium (He) and xenon (Xe), for the maintenance of the function of gas exchange in clinical settings was demonstrated by a number of researchers [1,[7][8][9]. The mixture of O 2 and He significantly reduces the resistance in the conductive system of the lungs facilitating the transport of O 2 to the terminal sections, while inhalation of a O 2 /Xe mixture due to the high lipophilicity of Xe implies its interaction with phospholipids of pulmonary surfactant, which has a direct effect on the gas exchange processes in the alveoli [8].…”

“…The effectiveness of inert gases, namely helium (He) and xenon (Xe), for the maintenance of the function of gas exchange in clinical settings was demonstrated by a number of researchers [1,[7][8][9]. The mixture of O 2 and He significantly reduces the resistance in the conductive system of the lungs facilitating the transport of O 2 to the terminal sections, while inhalation of a O 2 /Xe mixture due to the high lipophilicity of Xe implies its interaction with phospholipids of pulmonary surfactant, which has a direct effect on the gas exchange processes in the alveoli [8]. This was confirmed by high efficiency of contrast enhancement of the alveolar region of the lungs during inhalation of hyperpolarized Xe 129 during MRI diagnostics [10].…”

The Role of MARK ERK1/2 and p38 in Regulation of Functions of Neural Stem Cells and Neuroglia under Conditions of β-Amyloid-Induced Neurodegeneration

“…AD is characterized by a progressive impairment of cognitive functions and the loss of practical skills and self-care abilities, which ultimately leads to death due to causes unrelated to the underlying disease (infections, food aspiration, etc.). The development of these disorders occurs against the background of decompensation of adaptive mechanisms in various compartments of the nervous tissue [7,15]. The synthesis of neurotoxic β-amyloid peptides and the formation of neurofibrillary tangles are accompanied by a significant reorganization of the CNS and the formation of a qualitatively new pathogenic pattern of activity of individual brain structures [1,5].…”