Effects of Shen-fu injection on lung injury in a porcine model of hemorrhagic shock

Abstract

Background: Since it remains unclear whether Shen-fu injection (SFI) could be used in hemorrhagic shock (HS), this study aimed to explore the effects of SFI on lung injury caused by HS in a porcine model.
Methods: After HS induction, 32 pigs were allocated using simple randomization to four groups (n = 8 each): Group I (no resuscitation), Group II (shed blood reinfusion), Group III (reinfusion + saline 3 mL/kg), and Group IV (reinfusion + Shenfu injection 3 mL/kg). At 6 hours after HS, lung tissue was collected to measure IL‑6, IL‑8, IL‑4, and IL‑10 by ELISA, and to evaluate apoptosis by immunohistochemistry and transmission electron microscopy. Tissues from non‑survivors were obtained at the time of death and analyzed when available.
Results: Of the 32 randomized animals, 23 survived to 6 hours (Group I, 4/8; Group II, 6/8; Group III, 6/8; Group IV, 7/8). Cytokine analysis revealed that group IV exhibited significantly reduced levels of proinflammatory cytokines, including IL-6 and IL-8, concomitant with elevated concentrations of anti-inflammatory cytokines, specifically IL-4 and IL-10 (P < 0.05). Additionally, group IV demonstrated significantly elevated superoxide dismutase enzymatic activity, alongside enhanced Na⁺-K⁺-ATPase and Ca²⁺-ATPase activities, coupled with markedly reduced malondialdehyde levels (P < 0.05). Immunohistochemical analysis revealed downregulated caspase-3 expression and upregulated Bcl-2 expression in group IV, collectively indicating attenuated apoptotic activity. Ultrastructural examination of pulmonary tissues further demonstrated that SFI administration effectively ameliorated alveolar edema, hemorrhage, and inflammatory cell infiltration, while concurrently mitigating epithelial cell apoptosis and mitochondrial injury relative to the other experimental groups.
Conclusion: Among animals surviving to the 6‑hour assessment, SFI was associated with differences in selected inflammatory, oxidative‑stress, apoptosis, and histological markers. Because of differential mortality, small outcome‑specific sample sizes, and limited quantitative histology, these findings should be considered exploratory and do not establish improved survival or hemodynamic benefit.

Keywords

Hemorrhagic shock / Lung / Shen-fu

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