Name of the Procedure:

Infusion, Dextran 75, 500 ml (HCPCS Code: J7110)

Summary

Dextran 75 infusion is a medical procedure where a solution containing 75 grams per liter of dextran, a complex branched glucan (sugar), is administered intravenously to a patient. This procedure is typically utilized to manage volume expansion in patients.

Purpose

Dextran infusion is primarily used to:

• Treat hypovolemia (low blood volume).
• Improve microcirculation and blood flow. Its goal is to increase blood volume and improve blood circulation, which can help stabilize patients and improve oxygen delivery to tissues.

Indications

• Severe dehydration
• Blood loss due to surgery or trauma
• Shock
• Burn injuries
• Certain surgical preparations

Preparation

• The patient may be advised to fast for a few hours before the procedure if necessary.
• Pre-procedure assessments might include blood tests, blood pressure measurement, and overall health evaluation.
• Medication adjustments may be required based on the patient's medical history and current treatments.

Procedure Description

1. Initialization: Patient is positioned comfortably, and vital signs are monitored.
2. IV Insertion: A sterile intravenous (IV) line is inserted into a vein, usually in the arm.
3. Infusion: The dextran 75 solution is slowly administered through the IV line over a specified period.
4. Monitoring: Throughout the infusion, the patient's vital signs, such as blood pressure and heart rate, are closely monitored to detect any adverse reactions.

Tools and Equipment:

• Sterile IV catheter
• Infusion pump
• Dextran 75 solution (500 ml)

Anesthesia or Sedation: Not typically required, but local anesthesia may be used for IV insertion if needed.

Duration

The infusion can take from 30 minutes to a few hours, depending on the patient's needs and the infusion rate.

Setting

• Performed in a hospital, outpatient clinic, or sometimes a surgical center.

Personnel

• Registered Nurse (RN)
• Nurse Practitioner (NP)
• Physician or Specialist overseeing the procedure
• Medical Assistants (if required)

Risks and Complications

• Common: Mild swelling at the IV site, transient hypotension, allergic reaction.
• Rare: Severe allergic reactions, volume overload, anaphylactic shock.

Benefits

• Rapid restoration of blood volume.
• Improved tissue perfusion and oxygen delivery.
• Stabilization of vital signs in emergent situations.

Recovery

Immediate post-procedure care includes monitoring for any adverse reactions and ensuring that the patient is stable. The patient is usually advised to:

• Rest for a short period.
• Keep the IV site clean and monitored for signs of infection.
• Follow up with their healthcare provider if necessary.

Recovery time is typically short, with minimal restrictions post-infusion.

Alternatives

• Crystalloid solutions (e.g., saline or lactated Ringer’s solution).
• Other colloid solutions (e.g., albumin or starches).

Pros:

• Crystalloids are often more cost-effective.
• Different colloids may have a different safety profile.

Cons:

• Dextran provides more prolonged volume expansion compared to crystalloids.
• Dextran might be more efficient in specific clinical situations.

Patient Experience

During the procedure, patients might feel a cold sensation along the IV site or experience minimal discomfort at the insertion point. After the procedure, mild tiredness might occur, but proper hydration and rest usually help alleviate that. Pain management and comfort measures such as applying warm packs to the IV site or gentle movements can enhance patient comfort levels.