Exercise Induced Pulmonary Hemorrhage - Management and Treatment

Management and Treatment

A wide variety of treatments have been used or suggested for treatment of EIPH, including resting, anti-inflammatories (e.g. corticosteroids), bronchodilators, anti-hypertensive agents (including nitric oxide donors and phosphodiesterase inhibitors), conjugated estrogens (e.g. Premarin), antifibrinolytics (e.g. aminocaproic acid and tranexamic acid), snake venom, aspirin, vitamin K, bioflavinoids, diuretics (e.g. furosemide, known as Lasix or Salix), nasal strips (e.g. FLAIR Nasal Strips), concentrated equine serum (CES) and omega-3 fatty acids. Both the FLAIR Strips and the diuretic furosemide have been shown to have similar efficacy in reducing EIPH under laboratory and field conditions. A single study has shown that concentrated equine serum also reduced EIPH. There is currently no evidence to suggest that rest, bronchodilators, anti-inflammatory drugs, bioflavinoids, oestrogens, antifibrinolytics, aspirin, phosphodieterase inhibitors or surgical correction of upper airway obstructions reduce EIPH. In contrast, nitric oxide and aminocaproic acid have been shown to worsen EIPH.

Furosemide (Lasix) has been used to prevent the condition, although it does not work in 50% of cases, and it is banned in some countries. Other treatments that have been used include bronchodilators, coagulants, and estrogen.