Alberta Health Services is rationing the use of a "life-saving" drug for critical care patients after a shortage left the province's hospitals with just enough of the drug in reserve to last one week.

Sodium bicarbonate is an injectable drug that's commonly used in life-threatening medical situations in which a patient's blood becomes too acidic.

AHS is one of many healthcare authorities across North America facing a shortage of the drug due to a manufacturing issue by the drug's producer, Hospira Inc.

AHS had about six to seven weeks of the drug in reserve until June 15, when the producer issued a voluntary recall of sodium bicarbonate vials contaminated due to microbial growth found during testing. This recall left AHS with enough sodium bicarbonate in its reserve to last up to a week.

'Worst-case scenario'

"Six to seven days is a best guess estimate with respect to our stocks we have in reserve, but we anticipate in the next few days we'll have other strategies to alternate products or to other sources so we can drag that out a little bit longer," said Mauro Chies, vice-president of clinical support services.

"Six to seven days is kind of our worst-case scenario, but we think we can do better on that."

Sodium bicarbonate is used every day in critical care, operating room and emergency departments, said Dr. Francois Belanger, chief medical officer for AHS.

"It is used for patients that are critically ill and patients that have a buildup of acid within their system," Belanger said.

'It is really something that is life-saving'

This buildup of acid can come with patients who have septic shock or renal failure, he said. 

"For the patients that are more critically ill, it is really something that is life-saving and is used in critical care units," Belanger said. "If indeed we need sodium bicarbonate for life-saving situations, we want to ensure that we have it for those patients.

"The drug shortage is a serious issue and we are working hard to mitigate its effects."

'The drug shortage is a serious issue and we are working hard to mitigate its effects.' - Dr. Francois Belanger, chief medical officer for AHS


Belanger said the use of the drug in Alberta hospitals varies day by day, depending on the patient and their condition.

He said patients won't notice a difference "on the short term" due to the shortage.

AHS is currently managing the remaining stock by implementing an approval process before use to ensure the patients who need the drug most are getting it. 

Alternative treatments for patients are being sought, Belanger said, and other provinces are collaborating.

Looking into other sources

AHS is also working with Health Canada to look into off-shore supply options and to determine when the manufacturer will begin producing the drug again.

Chies said he expects to hear more about this timeline in mid-July or later.

AHS has even explored the idea of producing the drug itself, Belanger said, though he described that process as "complicated" and not the first option. 

"This is not the first time that we're experiencing drug shortage. We're working very diligently with other health jurisdictions and other provinces," he said.

"We're doing everything we can to obtain the drug from various sources."