0.9% Sodium Chloride Irrigation Shortage

• • 0.9% Sodium Chloride Irrigation, Baxter, 1000 mL Uromatic bag, 14 count, NDC 00338-0047-44
  • 0.9% Sodium Chloride Irrigation, Baxter, 1500 mL plastic pour bottle, 9 count, NDC 00338-0048-05
  • 0.9% Sodium Chloride Irrigation, Baxter, 2000 mL Uromatic bag, 6 count, NDC 00338-0047-46
  • 0.9% Sodium Chloride Irrigation, Baxter, 3000 mL Arthromatic bag, 4 count, NDC 00338-0047-27
  • 0.9% Sodium Chloride Irrigation, Baxter, 5000 mL Arthromatic bag, 2 count, NDC 00338-0047-29

• • Baxter had 0.9% sodium chloride irrigation on shortage due manufacturing delays.[1]
  • BBraun had 0.9% sodium chloride irrigation on shortage due to increased demand.[2]
  • Hospira had 0.9% sodium chloride irrigation on shortage due manufacturing delays and only has product available for existing customers.[3]

• • 0.9% Sodium Chloride Irrigation, BBraun, 1000 mL bottle, 16 count, NDC 00264-2201-00
  • 0.9% Sodium Chloride Irrigation, BBraun, 2000 mL bag, 4 count, NDC 00264-7388-50
  • 0.9% Sodium Chloride Irrigation, BBraun, 2000 mL bottle, 8 count, NDC 00264-2201-50
  • 0.9% Sodium Chloride Irrigation, BBraun, 3000 mL bag, 4 count, NDC 00264-7388-60
  • 0.9% Sodium Chloride Irrigation, BBraun, 4000 mL bottle, 4 count, NDC 00264-2201-70
  • 0.9% Sodium Chloride Irrigation, BBraun, 500 mL bottle, 16 count, NDC 00264-2201-10
  • 0.9% Sodium Chloride Irrigation, Baxter, 1000 mL plastic pour bottle, 12 count, NDC 00338-0048-04
  • 0.9% Sodium Chloride Irrigation, Baxter, 250 mL plastic pour bottle, 24 count, NDC 00338-0048-02
  • 0.9% Sodium Chloride Irrigation, Baxter, 3000 mL Uromatic bag, 4 count, NDC 00338-0047-47
  • 0.9% Sodium Chloride Irrigation, Baxter, 500 mL plastic pour bottle, 18 count, NDC 00338-0048-03
  • 0.9% Sodium Chloride Irrigation, Pfizer, 1000 mL bag, 12 count, NDC 00409-7972-05
  • 0.9% Sodium Chloride Irrigation, Pfizer, 1000 mL bottle, 12 count, NDC 00409-7138-09
  • 0.9% Sodium Chloride Irrigation, Pfizer, 1500 mL bottle, 9 count, NDC 00409-7138-36
  • 0.9% Sodium Chloride Irrigation, Pfizer, 2000 mL bag, 6 count, NDC 00409-7972-07
  • 0.9% Sodium Chloride Irrigation, Pfizer, 250 mL bottle, 24 count, NDC 00409-6138-22
  • 0.9% Sodium Chloride Irrigation, Pfizer, 3000 mL bag, 4 count, NDC 00409-7972-08
  • 0.9% Sodium Chloride Irrigation, Pfizer, 500 mL bottle, 24 count, NDC 00409-6138-03

Estimated Resupply Dates

• • Baxter has 0.9% sodium chloride 1000 mL and 2000 mL Uromatic bags and 1500 mL bottle on back order and the company cannot estimate a release date. The 0.9% sodium chloride 3000 mL and 5000 mL Arthromatic bags are on allocation.

Implications for Patient Care

• • Sodium chloride, lactated ringer's, and sterile water irrigations are all widely used.[4]

Safety

• • Clinicians may need to utilize different product sizes or packaging if desired sizes are not available.
  • Multiple brands of products may be available in the system.

Alternative Agents & Management

• • Make policies to allow substitution of products based on product availability at the site. For example, an organization could choose to allow lactated ringer's solution to be substituted for 0.9% sodium chloride solution. Table 1 provides a comparison of fluid components.
  • Evaluate the clinical need for irrigation fluid replacement. Discontinue irrigations when appropriate.
  • Use smaller bag sizes when possible.
  • Consider reserving some products for specific clinical situations.

  Table 1. Comparison of Selected Irrigation Fluids5-6

  Product	mOsm/L	Na (mEq/L)	Cl (mEq/L)	Dextrose (g/L)	K (mEq/L)	Ca (mEq/L)	Lactate (mEq/L)
  0.9% Sodium Chloride	308	154	154
  Lactated Ringer's Solution	274	130	109		4	3	28

  
  

References

• 1. Baxter (personal communications). August 14, November 7, 2014; January 28, March 9, May 4, July 6, and September 17, 2015.
  2. BBraun (personal communications). August 15, November 7, 2014; January 28, July 6, and September 23, 2015.
  3. Hospira (personal communications and website). August 15, November 7, December 2, 2014; January 28, March 9, and May 4, July 6, and September 17 and 23, 2015.
  4. McEvoy GK, Snow EK, Kester L, Litvak K, Miller J, Welsh OH, eds. AHFS DI (Lexi-Comp Online). Bethesda, MD: American Society of Health-System Pharmacists; 2014.
  5. Hospira. Lactated Ringer's Irrigation, USP [product information]. Lake Forest, IL: Hospira; 2009.
  6. Hospira. 0.45% Sodium Chloride Irrigation, USP, and 0.9% Sodium Chloride Irrigation, USP, [product information]. Lake Forest, IL: Hospira; 2009.