Dynamic mechanical consequences of deep inflation in mice depend on type and degree of lung injury

In a previous study ( Allen G, Lundblad LK, Parsons P, and Bates JH. J Appl Physiol 93: 1709 - 1715, 2002), our laboratory used deep inflations ( DI) in mice to show that recruitment of closed lung units can be a very transient phenomenon in lung injury. The purpose of this study was to investigate how this transience of lung recruitment depends on the nature and degree of acute lung injury. Mice were administered 50 mu l of either saline ( n = 8), 0.01 M ( n = 9) or 0.025 M ( n = 8) hydrochloric acid, or 50 mug ( n = 10) or 150 mug ( n = 6) of LPS and were mechanically ventilated 24 - 48 h later. At various levels of positive end- expiratory pressure, two DIs were delivered, and forced oscillations were used to obtain a measure of lung stiffness ( H) periodically over 7 min. After LPS exposure, pressure- volume curve hysteresis and recovery in H after DI were no different from saline- exposed controls despite 500 times more neutrophils in bronchoalveolar lavage fluid. Pressure- volume hysteresis and recovery in H were increased in acid- exposed mice ( P < 0.001) and were correlated with bronchoalveolar lavage fluid protein content ( R = 0.81). Positive end- expiratory pressure reduced recovery in H in all groups ( P < 0.01) but reduced pressure- volume hysteresis in the acid- injured groups only ( P < 0.001). We conclude that the effects of DIs in acute lung injury depend on the degree of lung injury but only to the extent that this injury reflects a disruption of the air- liquid interface.