Crisis: Life-Saving Fluids Shortage Deepens After Hurricane Helene! Credit | Pexels
United States: Long before Hurricane Helene forced the closure of an important intravenous fluid (IV) making factory in North Carolina, leading to alarms in hospitals across the country, many of the usual IV fluid shortages were evident in the United States.
What is IV fluid?
It is a concoction of Sodium chloride and water that has been in short supply since 2018, as the FDA drug shortage data revealed.
Saline drips to hydrate the body is one of the most common sights in hospitals. Sterile water that is used for mixing with medication, diluting other fluids, or rinsing wounds has been in shortage since 2021.
Helene’s damage to the Baxter International plant in North Carolina caused several other shortages, according to the FDA last week: another concentration of dextrose solution, an electrolyte solution called lactated Ringer’s, and a peritoneal dialysis solution for patients with renal failure.
Essential fluids – the lifeline of hospitals
And, as with essentially all drug shortages, it is about money at the end of the day, and IV fluids are not a money maker for the manufacturers, according to Erin Fox, the senior pharmacy director at the University of Utah Health.
“These are life-saving products, but at the same time, these are absolutely treated as kind of commodities,” Fox mentioned.
The high barriers to entry on the side of manufacturing are well known: Simply, it takes time and money to get the necessary regulatory approvals required to build a manufacturing plant; the pressures to manage costs mean that drug makers aren’t exactly eager to enter the market, Fox said.
IV fluids, she said, also require an extraordinary amount of space: For instance, a bag of saline – the quantity used in one treatment – is smaller than a loaf of bread and a little over 2 lbs in weight.
“So not just any space, but also has to be able to hold heavy weight,” Fox mentioned.
Moreover, to complicate matters, such products are even more complicated to make, including sterile or saline solutions.
According to Fox, “I know everyone is like, ‘It’s just salt and water! What do you mean?'” and “But making sure that everything is completely sterile and particle-free and really safe to give inside someone’s vein is a lot of work.”
According to Michael Ganio, who is a senior director of pharmacy practice and quality at the American Society of Health-System Pharmacists, a team that tracks drug shortages in the US, a major worrisome fact is that endotoxins, which is a toxic substance that appears in bacteria that can lead to a strong immune reaction in the body, not forgetting fever and inflammation.
Moreover, Endotoxins are majorly resistant to sterilization, which means manufacturers have to monitor and control their presence continuously.
