Pulmonary physiological and surfactant changes during injury and recovery from hyperoxia

The time course of lung injury and recovery from a sublethal exposure to 100% O2 was investigated in adult rabbits. Animals were exposed to 100% O2 for 64 h and then returned to room air for varying periods of time up to 200 h. By the end of the exposure period, the alveolar permeability to solute increased significantly, and biochemical analyses of bronchoalveolar lavages showed a 30% decline in phospholipid content and a threefold increase in protein levels. However, other parameters such as wet-to-dry lung weight ratios, blood gas values, and pressure-volume mechanics were not significantly different from control levels after 64 h of hyperoxia. Twenty-four hours postexposure, alveolar phospholipid levels had declined even further (51% of control), and mean protein levels in lavage increased to eight times control values. These lavages exhibited severely impaired dynamic surface activity at 37 degrees C and 100% humidity in an oscillating bubble apparatus. In addition, total lung capacity, lung compliance, and arterial O2 partial pressure declined greatly at this time. Between 12 and 48 h postexposure, animal mortality was 35%; the remaining animals survived, and physiological parameters returned to normal by 200 h postexposure. Bronchoalveolar lavages from the recovered animals contained protein levels equal to those of controls and phospholipid levels approximately twice those in control lavages. Lavage surface activity also returned to normal by the 200 h postexposure time point.