Effects of Shen-Fu injection on coagulation-fibrinolysis disorders in a porcine model of cardiac arrest

Am J Emerg Med. 2016 Mar;34(3):469-76. doi: 10.1016/j.ajem.2015.12.010. Epub 2015 Dec 12.

Abstract

Objective: The objective of the study is to investigate the effects of Shen-Fu injection (SFI) on coagulation-fibrinolysis disorders in a porcine model of cardiac arrest.

Materials and methods: Thirty Wuzhishan pigs were randomly assigned into the sham operation group (SO group, n = 6), epinephrine group (EP group, n = 12), and SFI group (n = 12). After 8 minutes of untreated ventricular fibrillation (VF), pigs in the EP group or SFI group were administered with either EP (0.02 mg/kg) or SFI (1.0 mL/kg), respectively. Plasma levels of tissue factor, thrombin-antithrombin complex, tissue factor pathway inhibitor, antithrombin III, protein C, tissue plasminogen activator, plasminogen activator inhibitor 1, soluble thrombomodulin, and soluble endothelial protein C receptor were measured at baseline, 1, 6, 12, and 24 hours after return of spontaneous circulation (ROSC). In addition, arterial lactate levels were measured at baseline, 1, 6, 12, and 24 hours after ROSC, and lactate clearance was calculated at 1, 6, 12, and 24 hours after ROSC.

Results: Compared with the EP group, tissue factor, thrombin-antithrombin complex, tissue factor pathway inhibitor, tissue plasminogen activator, and plasminogen activator inhibitor 1 levels were significantly lower, whereas antithrombin III and protein C levels were significantly higher in the SFI group (all P < .05). In addition, soluble thrombomodulin and soluble endothelial protein C receptor levels in the SFI group were significantly lower in comparison to the EP group (all P < .01). Furthermore, arterial lactate levels were significantly lower, and lactate clearance was higher in the SFI group (all P < .01).

Conclusions: This study demonstrates that SFI can inhibit coagulation-fibrinolysis disorders after cardiac arrest, which may be associated with alleviating endothelial damage and improving systemic metabolism.

MeSH terms

  • Animals
  • Blood Coagulation Disorders / drug therapy*
  • Blood Coagulation Disorders / etiology
  • Cardiovascular Agents / administration & dosage
  • Cardiovascular Agents / pharmacology
  • China
  • Disease Models, Animal
  • Drugs, Chinese Herbal / administration & dosage
  • Drugs, Chinese Herbal / pharmacology*
  • Epinephrine / administration & dosage
  • Epinephrine / pharmacology
  • Fibrinolysis / drug effects*
  • Heart Arrest / complications
  • Heart Arrest / drug therapy*
  • Injections
  • Phytotherapy
  • Resuscitation / methods
  • Swine
  • Swine, Miniature
  • Ventricular Fibrillation / drug therapy*
  • Ventricular Fibrillation / etiology

Substances

  • Cardiovascular Agents
  • Drugs, Chinese Herbal
  • Shen-Fu
  • Epinephrine