82163 Angiotensin II

Name of the Procedure:

Angiotensin II Infusion

Summary

Angiotensin II Infusion is a medical treatment where a synthetic version of the hormone angiotensin II is introduced into the bloodstream via an intravenous (IV) line. This hormone helps regulate blood pressure by constricting blood vessels.

Purpose

This procedure is intended for patients experiencing severe, resistant low blood pressure (hypotension), often seen in cases of septic or distributive shock. The goal is to increase blood pressure to safe levels, ensuring adequate blood flow to vital organs.

Indications

Angiotensin II Infusion is typically indicated for:

• Patients with septic shock not responding adequately to other vasopressors.
• Individuals with chronic low blood pressure unmanageable by alternative treatments.
• Critical care scenarios where rapid stabilization of blood pressure is crucial.

Preparation

• Patients may need to fast or follow specific dietary restrictions.
• Medication adjustments might be required; ongoing discussion with a healthcare provider is vital.
• Diagnostic tests such as blood pressure monitoring, blood tests, and organ function assessments are necessary.

Procedure Description

1. An IV line is inserted into a vein, usually in the arm.
2. Angiotensin II is prepared in a controlled, sterile environment.
3. The hormone is then infused through the IV line, with doses carefully monitored and adjusted based on patient response.
4. Continuous blood pressure monitoring ensures effectiveness and safety.

Tools/Equipment:

• IV line and infusion pump
• Blood pressure monitor

Anesthesia/Sedation:

• The procedure generally doesn't require anesthesia, but local numbing around the IV site may be used.

Duration

The infusion can last anywhere from a few hours to several days, depending on the patient's condition and response to treatment.

Setting

This procedure is performed in critical care settings such as an Intensive Care Unit (ICU) in a hospital.

Personnel

• Critical care physicians
• ICU nurses
• Pharmacists
• Possibly an anesthesiologist if sedation is required

Risks and Complications

Common risks:

• Hypertension (high blood pressure)
• Electrolyte imbalances

Rare risks:

• Allergic reaction to the drug
• Severe hypertension leading to organ damage

Complications are managed by adjusting the dosage or discontinuing the infusion and providing supportive care.

Benefits

• Rapid stabilization of blood pressure.
• Improved blood flow to vital organs.
• Increased chances of recovery from critical hypotensive events.

Recovery

• Continuous monitoring in the ICU for signs of improvement.
• Gradual weaning off the medication as blood pressure stabilizes.
• Follow-up appointments to monitor blood pressure and overall health.

Alternatives

• Other vasopressors (e.g., norepinephrine, vasopressin)
• Fluid resuscitation
• Each alternative has its own risk and benefit profile, which should be discussed with healthcare providers.

Patient Experience

During the infusion, patients often feel the insertion of the IV line, but generally do not experience pain. Monitoring equipment ensures patient comfort. Post-procedure, patients may feel fatigued or require assistance with mobility. Pain management and comfort measures such as sedation or analgesics may be provided as needed.