"The Drug Shortage Task Force provides information on the safe and consistent management of drug shortages as well as on additional resources and strategies.
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The SCCM Drug Shortage Alert: Electrolytes includes information on: 

• General Management Strategies
• Sodium Acetate Injection
• Concentrated Sodium Chloride Injection
• Potassium Acetate and Chloride Injection
• Phosphate Injection
• Calcium Chloride and Gluconate Injection
• Magnesium Sulfate Injection

The Society of Critical Care Medicine's Drug Shortages Committee is aware of ongoing and intermittent shortages of electrolytes used in the critically ill population. Up-to-date details regarding current drug shortages can be found on the American Society of Health-System Pharmacists Medication Shortage Page. Additional resources regarding electrolyte shortages can be found on the American Society of Parenteral and Enteral Nutrition Product Shortages web page.

Manufacturers report a number of reasons for these shortages, including increased demand, manufacturing delays, suspended production, and manufacturer discontinuation.

Lack of availability of any intravenous (IV) electrolyte can have serious consequences. As such, a multi-professional team should systematically analyze institutional usage patterns and automatic electrolyte replacement protocols and policies. Depending on current availability, routine usage of these IV electrolytes should be evaluated, and restrictive criteria (e.g. based on indication or severity of lab values (s)) may need to be implemented in order to conserve existing supply for critical patients and indications.

This summary provides information on the impact of electrolyte shortages in the intensive care unit; specifically, suggested management strategies, pharmacotherapeutic considerations, and safety considerations. These recommendations are based on a combination of the current evidence, clinical experience from multiple clinicians, as well as the consideration of the need for conservation during these shortages.

Updated January 2021

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