I always put stuff like that down to Sam and Dean being basically "bred" to be vessels for Archangels. Lucifer's temporary vessel was looking more like a corpse than a man by the time Sam said yes. In "The End", however, Lucifer had been in Sam for years and he looked better than ever. On top of which, Sam's got the demon blood.
They are definitely significantly more resilient than the average human. Part of it too though is that Sam definitely had blood on his lips when he went down which suggests internal injuries to me. Now he also could have just been punched in the face but i still think something beyond him was keeping him alive.
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