Lactated Ringer's Irrigation Shortage

• • Lactated Ringer's Irrigation Solution, BBraun, 3000 mL bottle, NDC 00264-7389-60

• • Baxter had lactated ringer's irrigation on shortage due to increased demand.[1]
  • BBraun had lactated ringer's irrigation on shortage due to increased demand.[2]
  • Hospira had lactated ringer's irrigation on shortage due to increased demand.[3]

• • Lactated Ringer's Irrigation Solution, BBraun, 1000 mL bottle, 16 count, NDC 00264-2203-00
  • Lactated Ringer's Irrigation Solution, BBraun, 2000 mL bottle, 8 count, NDC 00264-2203-50
  • Lactated Ringer's Irrigation Solution, BBraun, 4000 mL bottle, 4 count, NDC 00264-2203-70
  • Lactated Ringer's Irrigation Solution, Baxter, 1000 mL bottle, 12 count, NDC 00338-0114-04
  • Lactated Ringer's Irrigation Solution, Baxter, 3000 mL bag, 4 count, NDC 00338-0137-27
  • Lactated Ringer's Irrigation Solution, Baxter, 5000 mL 2 count, NDC 00338-0137-29
  • Lactated Ringer's Irrigation Solution, Pfizer, 3000 mL 4 count, NDC 00409-7828-08
  • Ringer's Irrigation Solution, BBraun, 1000 mL bottle, 16 count, NDC 00264-2202-00

Estimated Resupply Dates

• • Baxter, BBraun, and Hospira have product available to current customers.[1-3]
  • BBraun has the 3000 mL bottles for irrigation on allocation.

Implications for Patient Care

• • Lactated ringer's, sodium chloride, 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 0.9% sodium chloride solution to be substituted for lactated ringer's 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)	K (mEq/L)	Ca (mEq/L)	Lactate (mEq/L)
  Lactated Ringer's Solution	274	130	109	4	3	28
  0.9% Sodium Chloride	308	154	154

  
  

References

• 1. Baxter (personal communications). August 14, November 7, December 12, 2014; June 16, August 11, and October 27, 2015.
  2. BBraun (personal communications). August 15, November 7, 2014; January 8, 2015; June 16, August 11, and October 27, 2015.
  3. Hospira (personal communications and website). August 15, November 7 and 26, December 12 and 22, 2014; January 9, March 31, June 16, August 11, and October 27, 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.