Retrosternal pain is an early indicator of oxygen toxicity.
To determine the most sensitive early indicator of toxicity from exposure to O2, we measured respiratory clearance of 99mTc-diethylenetriamine pentaacetate (Tc-DTPA), pulmonary function, serum Factor VIII antigen, and plasma fibronectin values and monitored symptoms in six normal volunteers who breathed 21, 40, and 100% O2, administered in random order, for 17 h at least 1 wk apart. Twenty minutes after beginning O2, arterial PO2 differed among the three exposure groups. After exposure to the three concentrations of O2, there were no differences in Tc-DTPA clearance, vital capacity, FEV1/FVC, diffusing capacity, Factor VIII antigen, or fibronectin concentration. In contrast, all subjects complained of retrosternal pain during and after breathing 100% O2 (p less than 0.001). We conclude that with exposure to 100% O2, retrosternal pain, presumably from tracheal inflammation, occurs before detectable abnormalities of epithelial solute permeability (Tc-DTPA clearance), endothelial O2 injury (fibronectin concentration and Factor VIII), or pulmonary function. These findings indicate that symptoms are more sensitive than signs in detecting early O2 toxicity.
Montgomery
A B
AB
Chest Service, San Francisco General Hospital Medical Center, California.
Luce
J M
JM
Murray
J F
JF
D000328:Adult; D002637:Chest Pain; D005169:Factor VIII / Q000032:analysis; D005260:Female; D005353:Fibronectins / Q000032:analysis; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D009942:Organometallic Compounds; D010100:Oxygen / Q000097:blood / Q000506:poisoning*; D004369:Pentetic Acid; D011653:Pulmonary Diffusing Capacity; D016284:Technetium Tc 99m Pentetate; D014797:Vital Capacity
D005353:Fibronectins; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005169:Factor VIII; D010100:Oxygen; D016284:Technetium Tc 99m Pentetate