Hospitals across the U.S. are taking steps to conserve their supplies of IV fluids after Hurricane Helene struck a critical manufacturing plant belonging to the country’s biggest supplier.

Baxter International, a medical technology company responsible for making IV fluids for most U.S. hospitals, said Sunday that it would temporarily close production at its North Cove, North Carolina-based facility because of flooding from Helene, raising concerns about a potential nationwide shortage.

IV fluids are used to deliver drugs or water with electrolytes directly into a patient’s bloodstream. They’re also critical for surgery, when a person is unable to eat or drink, to keep them hydrated. Baxter also makes specialty fluids, such as peritoneal dialysis fluid, which helps patients with kidney failure filter waste from their blood, as well as irrigation fluids, used during procedures to clean or flush wounds.

There are four primary manufacturers of IV fluids in the U.S. Baxter is the leader, accounting for about 60% of the market.

The company is the main supplier for Mass General Brigham in Boston, which uses more than 100,000 liters of IV fluid from Baxter every month.

On a call Thursday with reporters, Dr. Paul Biddinger, Mass General’s chief preparedness and continuity officer, said the health system received a letter from Baxter that said that due to the temporary closure, the system would receive only 40% of its usual supply from the manufacturer.

The letter prompted the health system to take steps to conserve its supply, including, in some cases, providing options like Gatorade or plain water to patients instead of giving them IVs.

Biddinger said that it’s “too early to tell” what actions the healthy system might need to take if the supply shortage continues for several more weeks but that it’s considering switching to other suppliers.

“Patients are still getting IV fluids when they need them,” Biddinger said. “We are continuing normal medical services but emphasizing conservation, and we are carefully monitoring this incident to determine how long it may last, how long we may need to conserve, and making sure we identified all areas of our enterprise where services are affected.”

Hard to fill the gap

In a statement published online Thursday, Baxter said it doesn’t yet have a timeline for when operations will be back up and running.

A part of the problem, the company said, is that bridges to its site were damaged in the storm, limiting transport in and out.

The Department of Health and Human Services and the agency’s Administration for Strategic Preparedness and Response are working with Baxter to assess damage and help with recovery efforts.

A spokesperson for HHS said the government is focused on “reducing supply chain disruptions that may result from damage to the facility and surrounding infrastructure.”

In addition to Baxter, the spokesperson said, two other large manufacturers of IV fluids in the U.S. are also working to increase supply.

“FDA’s drug shortage office is in touch with Baxter about impacts to products manufactured at the facility and will continue to coordinate with FEMA to assist the company with cleanup of the facility,” the spokesperson said.

One of the manufacturers working to increase supply is B. Braun Medical, which accounts for about 23% of the IV fluids market, a company spokesperson said.

The spokesperson said the company is looking to increase the supply of the “most critical products” or “hospital workhorses,”

B. Braun Medical is also hiring new employees and hopes to be running 24/7 at two of its facilities in the coming weeks. It also has looked to bring in product from abroad; however, ports across the East and Gulf coasts are closed because of the port strike, compounding the issue.

Even so, it will be difficult to make up for the gap left by Baxter.

“We’re anticipating that there will be major constraints on the U.S. supply of IV fluids as a result of the production outage at Baxter’s North Cove plant,” the company’s spokesperson said in a statement.

ICU Medical, another IV fluid supplier, said it's monitoring for potential increases in demand.

The company has "already taken necessary steps to increase production to help meet market needs," spokesperson Harrison Richards said.

Hospitals prepare

In the meantime, hospitals are taking steps to make sure patients still have the IV fluids they need.

RWJBarnabas Health, based in New Jersey, said it’s taking “appropriate conservation measures” across its health system as it assesses the supply affected by Baxter.

“At this time, there is no impact to patient care,” said Carrie Cristello, a spokesperson for RWJBarnabas. “We will continue to monitor the situation closely.”

In a statement, Oregon Health & Science University Hospital, which was also affected by the Baxter closure, said it’s keeping its community informed of any changes that could be needed in patient care, research or education missions.

The hospital is also using oral hydration options when possible, as well as evaluating each patient for the discontinuation of continuous IV fluids.

Northwestern Medicine in Illinois said its supply chain team is discussing conservation efforts, as well.

“We anticipate this will be a long-term issue,” said Jenny Nowatzke, a spokesperson.

Berkeley Lovelace Jr. is a health and medical reporter for NBC News. He covers the Food and Drug Administration, with a special focus on Covid vaccines, prescription drug pricing and health care. He previously covered the biotech and pharmaceutical industry with CNBC.

Mustafa Fattah is a medical fellow with the NBC News Health and Medical Unit.