Patients fight for treatment as hospitals stockpile IV fluids after storm

Yvonne Hamz was determined to have a cancerous tumor. Her kidney was removed on Tuesday.

On Sunday, however, Hemze, 52, of Farmington, Minn., received a call from Abbott Northwestern Hospital that his surgery had been canceled. The hospital was reducing the supply of intravenous fluids needed for patients during surgery. Hurricane Helen damaged a Baxter International facility in North Carolina, leading to its temporary closure. The factory is the largest producer of intravenous fluids in the country.

Hemze said he has not been able to contact his doctor since the cancellation and fears his cancer is getting worse.

“Cancers won’t stop growing because they can’t have surgery,” he said.

On Thursday, shortly after NBC News reached out to Allina Health, a hospital chain that includes Abbott Northwestern, for comment, Hemze said he received a call from his doctor informing him that his surgery had been rescheduled for Friday. -Friday morning. In a statement, an Allina Health spokeswoman said the hospital was working to reschedule Thursday appointments and prioritize cases like Hemge's.

However, his case is not unique: Hospitals in the United States have said they are taking steps to conserve their supplies of intravenous fluids, including postponing or canceling any emergency surgeries. Whenever possible, patients receive Gatorade or water for hydration instead of intravenous solutions.

Intravenous fluids do more than deliver medications or electrolytes directly into a patient's bloodstream. They are needed during surgery to keep patients hydrated, control blood pressure and compensate for loss of fluids, including blood. Some intravenous fluids are used for patients with kidney failure; Others, as a form of intravenous nutrition.

“These are the lifeblood of hospital patients and if you cut off the hospital's supply of these critical intravenous fluids like normal saline and lactated Ringer's, it's almost like turning off the water in your house,” said Dr. Chris DiRienzo, neonatologist and head of the American Hospital Association. (Lacted Ringer is an electrolyte solution, like saline.)

There are only a few manufacturers of intravenous fluids in the U.S. and abroad, so any disruption could have a significant impact, he said.

Monday, the AHA asked President Joe Biden to declare a state of emergency nationwide due to the limited supply of intravenous fluids.

Supplies are running low

For Hannah Hale, 37, who lives in Dallas, Baxter's closure means her pharmacy will no longer be able to provide the dextrose solution she depends on.

There's a hell of Crohn's disease, and several surgeries over the years have left him with part of his small intestine, meaning his body is unable to absorb nutrients from his digestive system. He has relied on intravenous nutrition for more than eight years, which delivers nutrients directly into his bloodstream.

On Monday, her pharmacy told her they could no longer provide her with dextrose solution – an essential component of her intravenous nutrition – and advised her to switch to another pharmacy.

He called 14 other pharmacies but was unable to find any that could provide the medication. He had a story first reported by the New York Times.

“I had two more days of IV nutrition in my fridge,” Hale told NBC News on Thursday.

His doctor and pharmacist finally came up with the idea of ​​mixing electrolytes with a small amount of saline instead of dextrose, which he received on Wednesday. It's just a temporary solution – the pharmacist won't be able to do it again – and it will end in seven days.

“I don’t know what I’m going to do,” she said.

Working with the government

The federal government is working with Baxter to quickly resolve the supply issue.

The Food and Drug Administration reported this information on Wednesday. It will temporarily allow imports of IV fluids from Baxter factories in Canada, China, Ireland and the United Kingdom. It's not yet clear how long it will take for the product to reach the US. The FDA did not respond to a request for comment.

The Administration for Strategic Preparedness and Response (ASPR), an agency within the Department of Health and Human Services, is helping Baxter get its facilities back up and running.

The company said Wednesday that it expects to return to “90% to 100% allocation” of “certain intravenous solutions” by the end of the year.

Hospitals and distributors will also see an increase in supply of the most sought-after intravenous fluids: 40% to 60% and 10% to 60%, respectively.

ASPR is also working with B. Braun Medical, the nation's second-largest intravenous fluid manufacturer, to increase supply.

B. Braun Medical temporarily closed two of its facilities in Daytona Beach, Florida Hurricane Milton. However, Allie Longenhagen, a spokeswoman for the company, said Thursday that the facility was not damaged by the storm and that operations would resume Friday morning.

Two smaller manufacturers of intravenous fluids in the United States are ICU Medical and Fresenius Kaby. Spokespeople for each company said they have taken steps to increase supply.

'an urgent need'

The federal government and manufacturers must act quickly.

Paul Biddinger, director of preparedness and continuity at Mass General Brigham in Boston, said the health system has received fewer shipments since the Baxter facility closed.

When possible, steps should be taken to conserve your supply, including oral hydration – that is, Gatorade drinks or water – rather than the use of intravenous fluids.

“We texted our nurses, our doctors,” she said. “Whenever possible, we want people to find alternatives or eliminate waste.”

The lack of supply means patients will continue to struggle.

Robert, a 67-year-old mathematician from Chicago, has kidney disease. This week, he learned that the fluids he needed for dialysis were suddenly unavailable.

Robert – who asked that his surname not be used to protect his privacy – said his doctors struggled to find an alternative, forcing him to resort to longer treatments.

“There are people who won't do it for this reason, because I know that if I don't do dialysis every day, every day, I won't do it,” he said. “It is an urgent need.”