Stop the Flow: PCNL Outcomes Under Saline-Restricted Irrigation Conditions "Presentation" - Tyler Lunow-Luke
April 28, 2025
Tyler Lunow-Luke discusses a comparative study which demonstrates that percutaneous nephrolithotomy can be safely performed with significantly reduced saline irrigation volumes without compromising patient outcomes. This research provides valuable clinical guidance for urologists facing resource constraints following Hurricane Helene's disruption of IV saline production, suggesting that careful management of irrigation fluids during PCNL procedures remains a viable strategy during supply shortages.
Biography:
Tyler Lunow-Luke, Department of Urology, University of California, Irvine, Irvine, CA
Tyler Lunow-Luke, Department of Urology, University of California, Irvine, Irvine, CA
Read the Full Video Transcript
Tyler Lunow-Luke: Dear viewers, in September 2024, heavy flooding from Hurricane Helene led to the shutdown of a Baxter solutions facility in North Carolina, which produces approximately 60% of IV saline fluid in the United States. The resulting nationwide saline shortage prompted hospitals to restrict intraoperative saline irrigation use, including during percutaneous nephrolithotomy procedures. In this study, we reviewed outcomes of 10 PCNL procedures performed under saline restricted conditions, which were matched one-to-one with PCNL performed under unrestricted saline irrigation conditions.
Stone-free rate, post-op lab results, and hospital length of stay were compared between groups. For results, the residual stone burden was similar under saline-restricted and unrestricted conditions despite lower saline irrigation usage. Post-op hemoglobin, hematocrit, and creatinine did not vary between groups. In conclusion, our data demonstrate that PCNL performed under saline restricted conditions is safe and does not appear to impact postoperative outcomes or residual stone burden compared to unrestricted saline conditions. These findings support careful utilization of saline irrigation in PCNL, especially during times of resource shortage. Thank you.
Tyler Lunow-Luke: Dear viewers, in September 2024, heavy flooding from Hurricane Helene led to the shutdown of a Baxter solutions facility in North Carolina, which produces approximately 60% of IV saline fluid in the United States. The resulting nationwide saline shortage prompted hospitals to restrict intraoperative saline irrigation use, including during percutaneous nephrolithotomy procedures. In this study, we reviewed outcomes of 10 PCNL procedures performed under saline restricted conditions, which were matched one-to-one with PCNL performed under unrestricted saline irrigation conditions.
Stone-free rate, post-op lab results, and hospital length of stay were compared between groups. For results, the residual stone burden was similar under saline-restricted and unrestricted conditions despite lower saline irrigation usage. Post-op hemoglobin, hematocrit, and creatinine did not vary between groups. In conclusion, our data demonstrate that PCNL performed under saline restricted conditions is safe and does not appear to impact postoperative outcomes or residual stone burden compared to unrestricted saline conditions. These findings support careful utilization of saline irrigation in PCNL, especially during times of resource shortage. Thank you.