IV Solutions Supply Chain Disruptions

The Society of Critical Care Medicine (SCCM) is urging all hospitals and institutions to assess protocols related to fluid management to prepare for expected shortages.

A North Carolina facility manufacturing IV solutions for Baxter International was flooded by rains from Hurricane Helene, damaging supplies, raw materials, and local infrastructure required to access the facility. As a result, production has stopped until the situation is resolved. Baxter is working to assess the plant and determine what will be needed to bring it back into service.

Until regular production can resume, there will be supply chain disruptions for IV and other medical solutions. At the current time, this primarily affects large volume parenteral solutions (i.e., > 100 mls). The North Carolina plant is a major producer of IV solutions, supplying over 60% of fluids and products to the United States and other countries.

Hospitals are encouraged to implement or create a plan for limited IV solutions for the foreseeable future. Suggestions for management and conservation include careful assessment of clinical needs, utilizing methods to assess fluid responsiveness, discontinuing infusions as soon as appropriate, identifying alternative sources of solutions, optimizing oral fluid management, engaging interdisciplinary clinical teams, and maintaining clear communication with status and action plan adjustments.

SCCM is urging federal action to help mitigate supply chain issues. Check here for regular updates from Baxter. Baxter customers can call + 1 800 933-0303, option 1, during normal business hours, starting Monday, October 7, for clinical questions regarding conservation strategies.

• Be proactive about fluid management and assessment strategies.
• Prepare for long-term disruption. There is no timeline yet for when the supply chain will be stabilized.
• Communicate hospital-wide with other teams and leadership to develop short- and long-term strategies.

Key Resources for IV Fluid Shortages

• Small- and Large-Volume Fluid Shortages ‒ Suggestions for Management and Conservation (ASHP)
• ATS Clinical Recommendations: 10 Steps for Hospitals Facing Intravenous Fluid Shortages (Compiled in response to Hurricane Maria)

Additional SCCM Resources to Help During Drug Shortages

• Supply Chain Management During Outbreaks and Disasters
• Optimizing Fluid Stewardship in the ICU
• Finding Fluid Stewardship In the ICU
• Mitigation for Medication Shortages
• Importance of Effectively Communicating Drug Shortages
• Navigating Hospital Drug Shortages: Bringing the Team Together
• Multidisciplinary Management of Drug Shortages and Associated Ethical Dilemmas