Name of the Procedure:

Common names: Hemin Injection
Technical or medical term: Injection, hemin, 1 mg (HCPCS Code: J1640)

Summary

Hemin injection is a medical procedure involving the administration of hemin, which is used primarily to treat certain blood-related conditions by reducing the production of specific substances in the body that can cause severe symptoms.

Purpose

Hemin injection is used to manage acute attacks of porphyria, a group of disorders caused by abnormalities in the chemical steps leading to hemoglobin production. The primary goal is to alleviate symptoms such as severe abdominal pain, vomiting, and neurological complications by slowing down the body's production of heme, thus decreasing the accumulation of toxic porphyrin precursors.

Indications

• Acute intermittent porphyria
• Symptoms requiring the reduction of acute porphyrin levels
• Patients with a confirmed diagnosis of porphyria who are experiencing an acute attack

Preparation

• Patients may need to fast for a few hours before the injection.
• Necessary blood tests to determine porphyrin levels and assess liver function.
• Patients should inform their healthcare provider of any medications they are currently taking to avoid potential interactions.

Procedure Description

1. Site Preparation: The injection site, usually a vein, is cleaned to prevent infection.
2. Administration: A healthcare professional administers the hemin injection intravenously.
3. Monitoring: Patient is monitored for any adverse reactions immediately following the injection. Tools and equipment include syringes, needles, and IV bags. Anesthesia is not typically required, but some patients may receive a local anesthetic to minimize discomfort.

Duration

The injection itself takes only a few minutes, but observation for adverse reactions may extend the total time to about 1 to 2 hours.

Setting

Hemin injections are usually performed in a hospital or outpatient clinic equipped to handle intravenous treatments and monitoring.

Personnel

The procedure is typically carried out by:

• Nurses
• Physicians or specialized healthcare providers
• Additional support staff if required for monitoring

Risks and Complications

Common risks:

• Injection site reactions (redness, swelling)
• Mild fever Rare risks:
• Allergic reactions (rash, itching, breathing difficulties)
• Thrombophlebitis (vein inflammation)
• Potential liver function changes

Benefits

• Relief from the severe symptoms of acute porphyria attacks.
• Reduced frequency and severity of attacks with effective management. Benefits are often realized within a few hours to days.

Recovery

• Patients may need to rest for a short period after the injection.
• Follow-up appointments may be necessary to monitor porphyrin levels and overall health.
• Patients should avoid strenuous activities for at least 24 hours post-injection.

Alternatives

• Medications like glucose infusions that can help manage mild attacks.
• Diet and lifestyle changes to avoid known triggers of porphyria attacks. Pros and cons should be discussed with a healthcare provider to determine the best treatment approach.

Patient Experience

During the procedure:

• Patients might feel a slight sting or pressure at the injection site.
• Mild discomfort or a sense of cold as the injection is administered.

After the procedure:

• Temporary soreness at the injection site.
• Monitoring for a few hours to ensure no adverse reactions occur.
• Pain management options such as acetaminophen may be provided for any minor discomfort. Comfort measures include warm compresses for the injection site and hydration.