In recent months, hospitals and health care systems across
the U.S. have experienced shortages of normal saline and other intravenous (IV)
fluids that are critical to patient care. A range of factors, including a
reported increase in demand by hospitals and other providers, as well as
production interruptions from the manufacturers of these products, triggered
the shortage. The U.S. Food and Drug Administration (FDA) reported that it will
take several months to address the issue.
As a result, in a letter to the FDA, the
American Hospital Association (AHA) urged the agency to vigorously pursue
additional supplies and suppliers of normal saline and other IV fluids to ease this
shortage and prevent future shortages. Recently, the FDA announced that it will
allow a Norwegian maker of normal saline solution to temporarily import product
to help address the critical shortage. The product is made by Fresenius Kabi
USA in its Norway manufacturing facility, which has been inspected by FDA, and
it has the same active ingredient in the same concentration as 0.9% sodium
chloride injection products approved in the U.S.
"The current shortages of IV fluid are unacceptable and
must be resolved quickly to prevent a negative impact on patient care,"
wrote AHA Executive Vice President Rick Pollack in the letter to the FDA.
"Currently, hospitals are scrambling to manage the shortfall and have
employed strategies including using smaller IV bags, switching patients to
appropriate alternatives and prioritizing patients based on clinical factors.
While these strategies have somewhat mitigated the problem to date, the AHA is
concerned that patients could face harm in the future if these shortages are
not resolved quickly."
The Drug Information Service of the University of Utah, in
collaboration with the American Society of Health-System Pharmacists (ASHP),
has compiled a guide, “IV Fluid Conservation Strategies,” to assist hospitals and health care systems seeking ways
to manage shortages by conserving existing supplies of IV solutions and minimizing
waste. The AHA is asking hospitals to share the document with pharmacy,
medical and nursing leadership, materials managers and others who are involved
in addressing the current IV fluid shortage. Roslyne D. W. Schulman, Director of Policy Development,
American Hospital Association