Protective effects of Shen-fu injection on hemodynamic parameters and lung injury in a porcine model of hemorrhagic shock

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, we randomly assigned 32 pigs into 4 groups: group I (n = 8, no resuscitation); group Ⅱ (n = 8, resuscitated with shed blood); group III (n = 8, resuscitated with shed blood and saline at a dose of 3 mL/kg); and group IV (n = 8, resuscitated with shed blood and SFI at a dose of 3 mL/kg. After 6 hours of HS, we analyzed interleukin (IL)-6, IL-8, IL-4, and IL-10 levels of lung tissue using an enzyme-linked immunosorbent assay. Apoptosis in the lung was evaluated using an immunohistochemistry staining assay and transmission electron microscopy. Results: In a porcine model of HS, 23 of 32 animals survived for 6 hours across 4 groups. 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 Ca 2+ -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: SFI may protect against lung injury in a porcine HS model.