Reason for the Shortage

• • Baxter has Exactamix valve sets available.

Available Products

• • Exactamix Valve Set, Baxter, 1200 Valve Set, 10 count, Product H938792
  • Exactamix Valve Set, Baxter, 2400 Valve Set, 10 count, Product H938724

• • Baxter has Exactamix 1200 and 2400 valve sets available.

• • Baxter has provided guidance on the Exactamix 2400 Valve Set due to the potential for the risk of incorrect final admix from leaking valves. The information can be found at: https://www.ashp.org/-/media/assets/drug-shortages/docs/FA-2022-024-baxter-exactamix-customer-letter.pdf.

• • The joint guidance document on supply disruption considerations can be found here: ASHP, ASPEN, ISMP, NHIA Joint ExactaMix Valve Set Supply Disruption Considerations
  • No single strategy will work for all health-systems and all are less than ideal for providing patient care and preparing total parenteral nutrition (TPN).
  • Consider extending the use of the valve set if it's not being used for pumping lipids (up to 150L limit).
  • Consider pumping 2 days of TPN within 24 hours (e.g. set up at noon, pump that day's TPN (late) then pump the next day's TPN before noon (early). This strategy will require careful coordination of both orders and labs.
  • Consider pumping multiple days of TPN. This strategy may lead to excess waste of TPN components that are also in short supply (see American Society for Parenteral and Enteral Nutrition recommendations). https://www.nutritioncare.org/Productshortages/
  • Consider purchasing a different compounder with assured supply of components. This strategy is time consuming and costly.