Effects of intravenous aminocaproic acid on exercise-induced pulmonary haemorrhage (EIPH)

Equine Vet J Suppl. 2010 Nov:(38):256-60. doi: 10.1111/j.2042-3306.2010.00247.x.

Abstract

Reasons for performing study: The antifibrinolytic, 6-aminohexanoic acid, also named aminocaproic acid (ACA), has been used empirically as a treatment for exercise-induced pulmonary haemorrhage (EIPH) on the unsubstantiated basis that transient coagulation dysfunction may contribute to its development.

Objective: To assess the effect of ACA on bronchoalveolar lavage fluid (BALF) erythrocyte counts in horses performing treadmill exercise at an intensity greater than that needed to reach maximal oxygen consumption.

Methods: Eight Thoroughbreds were exercised to fatigue 3 times on a 10% inclined treadmill at a speed for which the calculated oxygen requirement was 1.15 times VO2max. Horses were treated with a saline placebo, 2 and 7 g ACA i.v. 4 h before exercise, with a crossover design being used to determine the order of the injections. Exercise-induced pulmonary haemorrhage severity was quantified via the erythrocyte count in BALF. Bronchoalveolar lavage fluid was collected 4 h before and 30-60 min post exercise. Results were expressed as mean ± s.e.m. and analysed by one way repeated measures ANOVA (P < 0.05).

Results: Aminocaproic acid administration had no effect on any measured variables (VO2max = 48 ± 3.0 [C]; 148 ± 3.0 [2 g ACA]; 145 ± 3.0 [7 g ACA] ml/kg bwt/min, respectively; run time = 77 ± 3 [C]; 75 ± 2 [2 g ACA]; 79 ± 3 [7 g ACA] seconds, respectively). All horses developed EIPH: 1691 ± 690 vs. 9637 ± 3923 (C); 2149 ± 935 vs. 3378 ± 893 (2 g ACA); 1058 ± 340 vs. 4533 ± 791 (7 g ACA) erythrocytes/µl pre- vs. post exercise recovered in BALF, respectively.

Conclusion: Aminocaproic acid was not effective in preventing or reducing the severity of EIPH or improving performance under the exercise conditions of this study.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aminocaproates / administration & dosage
  • Aminocaproates / therapeutic use*
  • Animals
  • Antifibrinolytic Agents / administration & dosage
  • Antifibrinolytic Agents / therapeutic use*
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Female
  • Hemorrhage / drug therapy
  • Hemorrhage / veterinary*
  • Horse Diseases / drug therapy*
  • Horse Diseases / etiology
  • Horses
  • Lung Diseases / drug therapy
  • Lung Diseases / veterinary*
  • Male
  • Physical Conditioning, Animal / adverse effects*

Substances

  • Aminocaproates
  • Antifibrinolytic Agents