Evaluation of the protective effect of direct peritoneal resuscitation on lung injury in a controlled hemorrhagic shock model in rats

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are severe complications following hemorrhagic shock, leading to significant morbidity and mortality. Direct peritoneal resuscitation (DPR) has been proposed to improve microcirculation and reduce organ damage, but its effects on lung injury have not yet been fully explored. Does direct peritoneal resuscitation with peritoneal dialysis fluid (PDF) reduce lung injury in a controlled hemorrhagic shock model in rats? In this randomized experimental study, 32 male Wistar albino rats were randomly assigned to four groups (n = 8 per group). Group I served as the control group, while Groups II, III, and IV underwent hemorrhagic shock. Group III received peritoneal resuscitation with saline, and Group IV received PDF. Lung tissue samples were harvested after 24 h to assess histopathological damage and inflammatory markers; Interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α) levels. DPR with PDF significantly attenuated lung injury compared to saline-treated or hemorrhagic shock-only groups. Interstitial polymorphonuclear leukocytes (PMNL) infiltration and alveolar septal thickening were reduced in the DPR group. Additionally, IL-6 levels were elevated in the DPR group, suggesting a potentially enhanced localized inflammatory response, while no significant differences were found in IL-10 and TNF-α levels. Direct peritoneal resuscitation with PDF was effective in reducing lung injury in rats subjected to hemorrhagic shock by improving microcirculatory function and modulating the inflammatory response. However, the elevated IL-6 levels suggest further investigation is needed to understand the long-term implications of this inflammatory response.