Hyperoxia damages phagocytic defenses of neonatal rabbit lung

The effect of hyperoxia on phagocytic defenses of neonatal rabbit lung was ascertained by exposure to a fractional inspired O2 concentration of 0.95 + or 0.21 for 48, 96, or 168 h. Intrapulmonary clearance of inhaled staphylococci was reduced by 67 and 74% after 96 and 168 h in hyperoxia (P less than 0.05). Impaired phagocytic killing was not due to diminished bacterial ingestion. Alveolar macrophages (AM) lavaged from pups reared in normoxia had a progressive ability to release superoxide (O-2) and showed increasing cyanide-sensitive O2 consumption during the 1st wk of life. Conversely, AM recovered from litters housed in hyperoxia for 48 h produced 190% more O-2 than normoxic controls (P less than 0.005), but this capacity to generate O-2 fell by 43% after 96 h of exposure (P less than 0.05). After 96 h of hyperoxia, AM had a significant shift toward cyanide-insensitive metabolism compared with normoxic cells (P less than 0.05). Polymorphonuclear leukocytes (PMN) entered the alveoli after 96 h of hyperoxia, and mortality rose abruptly in animals exposed for 168 h (16%) vs. 96 h (3%). Our findings indicate neonatal hyperoxia induces metabolic and bactericidal dysfunction in the primary pulmonary phagocyte, the AM, and this injury is followed by additional lung insult during PMN migration into the airways.