IR UpFront Recommendations for IV usage amidst the current
fluid shortage On Oct. 9, SIR published a series of recommendations for IR practices to consider when using IV fluids during the current shortage. Baxter International’s Marion, N.C., facility suffered catastrophic damage from Hurricane Helene. As a result, Baxter has suspended operations at the plant, which supplies 60% of IV fluids used in the United States. While the FDA has authorized foreign imports, any facility still facing shortages should make every effort to conserve their supply of IV fluids at this time. SIR emphasizes the importance of prioritizing patient care and suggests that facilities implement strategies to manage the shortage and ensure continuity of care. As always, use your best clinical judgment as you consider mitigation strategies.
Recommendations
• Avoid routinely starting IV fluids on any same-day admissions or outpatients in the periprocedural area.
• Reduce maintenance IV fluids to the minimal possible volume and replace IV fluids with oral hydration when possible.
• Use smaller saline bags when possible and make every attempt to prevent waste. • Limit NPO time to no more than 8 hours pre-procedure. • Encourage patients to liberalize their oral intake of clear fluids up to 2 hours before procedures to minimize preprocedural dehydration and need for IV fluid resuscitation.
• Use smaller saline flushes for back table set up in non-vascular procedures and in some minor vascular access procedures.
• Consider performing clinically equivalent procedures that minimize IV fluid usage (e.g., single session thrombectomy rather than thrombolysis or pulse spray methods that require IV fluids).
• Consider oral or subcutaneous agents whenever possible for anticoagulation instead of IV heparin pre- and post-procedure.
• Consider limiting elective cases that require saline irrigation such as percutaneous lithotripsy and stone retrieval.
Additional recommendations for consideration are available on the ACEP website and the North Carolina Medical Society website.
SIR members are encouraged to stay informed about this national shortage and to communicate openly with their teams and patients regarding any changes to procedural plans. SIR remains committed to supporting interventional radiologists through this challenging time, advocating for solutions to ensure that patient care is not compromised.
SIR member awarded Best Scientific Paper at CIRSE 2024
Martha-Gracia Knuttinen, MD, PhD, of the Mayo Clinic Comprehensive Cancer Center in Phoenix, was awarded Best Scientific Paper at CIRSE 2024. The abstract, “Pelvic venous disorders (PeVD): pre and post treatment symptom assessment—results from a prospective multi-site clinical trial” investigates whether treating pelvic vein abnormalities in patients with pelvic venous disorders (PeVD) can result in symptom improvement of comorbid conditions.
According to Dr. Knuttinen and her coauthors, the data suggested that PeVD should be considered as a possible cause of pelvic pain, lower extremity pain and deep vein thrombosis, and may be associated with symptoms such as bladder and bowel symptoms, migraine headaches, and orthostatic intolerance. The authors recommend further prospective randomized trials for patients with these symptoms.
Congratulations to Dr. Knuttinen and her team for bringing award-winning IR research to the forefront!
8 IRQ | FALL 2024 In memoriam
Andrew B. Crummy, MD, FSIR, founding SIR member and former SIR president
Founding SIR member and former SIR President Andrew B. Crummy, MD, FSIR, passed this October. He was one of the first interventional radiologists and was present at the first meeting of the society on Jan. 17, 1975.
Dr. Crummy was a 2011 SIR Gold Medalist, served on numerous SIR committees, and had more than 200 publications in numerous medical journals, including the Journal of Vascular and Interventional Radiology, and presented over 300 papers. His work in the development of digital subtraction angiography and pioneering embolization of the kidney and biliary tract were pivotal for the field of interventional radiology. Dr. Crummy helped SIR to grow by championing the expansion of the society’s membership, allowing it to flourish as the member-driven nonprofit that exists today.
He also served as a leader in the Dane County Cancer Society, The Wisconsin Radiological Society and the State Medical Society of Wisconsin. He has been honored with a Gold Medal from the Roentgen Ray Society and the Wisconsin Radiological Society Flaherty Lifetime Achievement Award. Read Dr. Crummy’s reflections on the early years of IR.
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