Shen-fu injection attenuates postresuscitation lung injury in a porcine model of cardiac arrest

Abstract

Objective: To investigate the effects of Shen-Fu injection (SFI) on postresuscitation lung injury in a porcine model of cardiac arrest.

Methods: Twenty-four anaesthetised male Landrace pigs were subjected to 4 min of untreated ventricular fibrillation (VF), followed by standard cardiopulmonary resuscitation. Sixteen successfully resuscitated pigs were randomised into two groups (eight pigs per group); one group received an SFI infusion and the other group received a normal saline infusion, at an infusion rate of 0.24 mg/min from 15 min after the return of spontaneous circulation (ROSC) until 6h after ROSC.

Results: Oxygenation index, respiratory index, oxygen delivery, oxygen consumption, oxygen extraction, dynamic lung compliance, airway resistance, external vascular lung water index, and pulmonary vascular permeability index at 15 min, 30 min, 1h, 2h, 4h, and 6h after ROSC were all worse than baseline in the saline group, and were all better in the SFI group than in the saline group. The pulmonary protective effects of SFI were further confirmed by histopathological and ultrastructural observations of lung tissue. SFI infusion resulted in lower apoptosis index, caspase-3 protein expression, and malondialdehyde content of lung tissue after ROSC, and increased Bcl-2 protein expression and superoxide dismutase, Na+ -K+ -ATPase, and Ca2+ -ATPase activity compared with the saline group.

Conclusion: Shen-Fu injection can attenuate postresuscitation lung injury through suppression of lung cell apoptosis and improvement of energy metabolism and antioxidant capacity.