Guest Post: Hospitals Combatting Shortages of IV Fluids, Urge FDA to Act Swiftly, by Roslyne Schulman, American Hospital Association

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