Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, w
CPT4 code
Name of the Procedure:
Pharmacologic Agent Administration (e.g., inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agents)
Summary
Pharmacologic agent administration involves the delivery of specific medications directly into the bloodstream or through inhalation to treat various cardiovascular and respiratory conditions. The procedure includes monitoring hemodynamic measurements before, during, and after medication administration to ensure the patient’s stability and effectiveness of the treatment.
Purpose
This procedure addresses conditions like pulmonary hypertension, heart failure, and acute decompensated heart failure. The goal is to improve heart function, reduce symptoms, and stabilize the patient's condition.
Indications
- Pulmonary hypertension
- Acute heart failure
- Cardiogenic shock
- Severe hypertension
- Situations requiring hemodynamic support
Preparation
Patients may need to fast for a few hours before the procedure. Blood tests, ECGs, and echocardiograms may be required to assess baseline cardiac function and other relevant parameters.
Procedure Description
- Preparation: The patient is placed in a comfortable position, and vital signs are recorded.
- Insertion of IV Line: If not already in place, an intravenous (IV) line is inserted for medication administration.
- Baseline Hemodynamic Measurements: Initial measurements (e.g., blood pressure, heart rate, oxygen saturation) are taken.
- Administration of Pharmacologic Agent: The specific medication is administered as prescribed, either via inhalation (for gases like nitric oxide) or intravenously.
- Monitoring: Hemodynamic measurements are continuously monitored during the procedure.
- Post-Administration Assessments: After the medication is delivered, hemodynamic measurements are taken again to assess the patient’s response.
- Repeat Administration: If necessary, the pharmacologic agent administration may be repeated based on the patient's response.
Various devices like infusion pumps and monitoring equipment are used. Sedation or anesthesia is typically not required except in specific cases.
Duration
The procedure typically takes 30 minutes to several hours, depending on the medication and patient response.
Setting
The procedure is usually performed in a hospital setting, such as an intensive care unit (ICU) or cardiac care unit (CCU).
Personnel
- Cardiologists or critical care physicians
- Nurses specialized in critical care
- Respiratory therapists (if inhaled agents are used)
Risks and Complications
- Hypotension (low blood pressure)
- Arrhythmias (irregular heartbeats)
- Rebound hypertension
- Allergic reactions
- Drug toxicity
Benefits
The expected benefits include stabilization of heart function, improved oxygen delivery, and symptom relief. Effects are often noticeable within minutes to hours after administration.
Recovery
Post-procedure care involves continuous monitoring of vital signs and hemodynamic parameters. Patients may receive additional medications or interventions if required. Recovery time varies; patients may need to remain in the hospital for further observation and treatment.
Alternatives
Alternatives may include oral medications, non-pharmacologic interventions like mechanical ventilation or intra-aortic balloon pumps, and surgical options such as heart transplantation. Each alternative has its own benefits and risks compared to pharmacologic agent administration.
Patient Experience
Patients may feel a slight discomfort from the IV insertion but should not experience significant pain during the procedure. Continuous monitoring ensures patient comfort and safety, and any pain or discomfort can be managed with appropriate medications and support.
This markdown captures the details of pharmacologic agent administration for medical professionals who might need a structured overview of the procedure.