Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Favorite

Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentation 3 - Care Equity, Quality and Safety

Ripple Effects of IV Fluid Shortage: Impact on Elective Pediatric Otolaryngological Surgery

Monday, October 13, 2025

10:18 AM - 10:24 AM EDT

Location: 107-108

Disclosure(s):

Nicole M. Favre, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Chinelo J. Eruchalu, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Alex P. Bogosian, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: In September 2024, the Baxter International plant in Marion, North Carolina was damaged by Hurricane Helene resulting in the plant’s closure. This facility had been responsible for supplying 60% of US intravenous (IV) fluids. IV shortages ensued. How did this affect elective otolaryngological surgery in children nationwide?

Methods: A retrospective study was conducted using TriNetX, a global EHR database, to identify patients less than 18 years of age who underwent tonsillectomy from September to November in 2023 and 2024 in the US. Patients diagnosed with dehydration (ICD-10 E86.0) or who were evaluated in the emergency department (CPT 99281-5) within two weeks of the procedure were tabulated. Weekly trends of tonsillectomy rates and incidence of postoperative complications were compared utilizing Wilcoxon rank-sum and Chi-square tests.

Results: The total number of pediatric tonsillectomies performed between September and November was 9,270 in 2023 and 7,439 in 2024. The weekly number of pediatric tonsillectomies during this time frame was significantly lower in 2024 (median=613, IQR=566-614) compared to 2023 (median=720, IQR=701-774; W=94, z=-3.09, p=.001). Post-tonsillectomy dehydration and emergency department visits were too rare to compare weekly, but there was no statistically significant difference overall between 2023 and 2024 in dehydration (N=158, 1.7% vs. N=119, 1.6%; p=.39) or emergency department visits (N=624, 6.7% vs. N=475, 6.4%; p=.64).

Conclusions: There is evidence that pediatric tonsillectomy rates declined following the onset of the IV fluid shortage in the US but more work is needed to determine if there is a causal connection.

Presenting Author(s)

Nicole M. Favre, MD

Resident Physician
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

CC

Chloe J. Cottone, BA

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Bufalo, NY, United States

Disclosure information not submitted.
Chinelo J. Eruchalu, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Alex P. Bogosian, BS

Medical Student
Touro College of Osteopathic Medicine- Middletown
Buffalo , New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
GV

Gaayathri Varavenkataraman, MA

Research Assistant
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
East Amherst, New York, United States

Disclosure information not submitted.

Senior Author(s)

MC

Michele M. Carr, DDS MD PhD

Professor
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Williamsville, New York, United States

Disclosure information not submitted.