Background: A natural disaster, Hurricane Helene, damaged a production facility supplying 60% of intravenous (IV) fluids in the United States. A nationwide IV fluid shortage followed.
Objectives: To evaluate a multifaceted IV fluid conservation intervention’s effect on IV fluid utilization and clinical outcomes during the shortage.
Methods: Retrospective, quasi-experimental study using interrupted time series and multivariable regerssion at the University of Utah Hospital, an 817-bed academic medical center. Inpatient admissions to surgical, medical, or obstetrics and gynecology services between July 1, 2024 and January 1, 2025 were included. The intervention comprised system-wide communications, health record modifications, leadership meetings, and real-time monitoring. The primary outcome was IV fluid utilization; secondary outcomes were length of stay, diuretic administration, acute kidney injury, renal replacement therapy, ICU transfer, hypotension, and inpatient and 30-day mortality.
Results: A total of 15,847 admissions were analyzed, including 8164 preintervention and 7683 postintervention admissions. Mean age was 52.9 years; 8621 (54.4%) were female. IV fluid utilization decreased from a mean (95% confidence interval [CI]) of 5.5 (5.3-5.7) bags to 3.5 (3.4-3.6) bags per admission following the intervention (p < .001). Length of stay decreased by 0.6 days postintervention (p < .001). Loop diuretic administration decreased (odds ratio [OR] = 0.87 [0.79-0.95]; p = .001), and an increase in acute kidney injury was observed (OR = 1.1 [1.0-1.3]; p = .024). No significant differences were observed for renal replacement therapy, ICU transfer, hypotension, or mortality outcomes.
Conclusions: Reductions in IV fluid utilization, diuretic administration, and length of stay were observed following an IV fluid conservation intervention. Our strategies offer a framework for health systems facing similar shortages with the potential to improve clinical outcomes.
Reference:Johnson SA, Fox ER, Warrier S, Vinik R. Resource management and clinical outcomes during a national intravenous fluid shortage. J Hosp Med. 2026 May 15. doi: 10.1002/jhm.70352. Epub ahead of print. PMID: 42138344.