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The answer comes down to what "sterile" and "0.9%" actually require at a pharmaceutical level and why falling short of either standard creates contamination risk that is invisible until something goes wrong

Popescu M, Bratu A, Agapie M, Borjog T, Jafal M, Sima RM, Orban C (2024) The use and potential benefits of N -acetylcysteine in non-acetaminophen acute liver failure: an etiology-based review

[Abstract]2022 May;22(5):1362-1371

We detected a statistically significant reduction in VEGF in three PCa cell lines (PC-3, DU-145, LNCaP) whereas CXCL8 release was significantly downregulated mostly in DU-145 and LNCaP cells exposed to ALCAR (Fig