From the Guidelines
D5 1/2 NS IV fluid should not be used as a first-line maintenance fluid in children due to the risk of hyponatremia, instead, isotonic solutions with appropriate KCl and dextrose are recommended 1.
Uses of D5 1/2 NS IV Fluid
- D5 1/2 NS IV fluid is a solution containing 5% dextrose (glucose) and 0.45% sodium chloride (half-normal saline) used primarily for fluid replacement, electrolyte maintenance, and providing calories.
- This fluid is particularly useful in patients who need both hydration and some glucose supplementation, such as those with mild dehydration, hypoglycemia, or those requiring maintenance fluids.
- The dextrose component provides approximately 170 calories per liter and helps prevent ketosis and protein breakdown, while the half-normal saline provides sodium and chloride at concentrations that help maintain electrolyte balance without causing fluid overload.
Administration and Precautions
- D5 1/2 NS is commonly used in patients who cannot take oral fluids, those recovering from surgery, or patients with conditions like diabetic ketoacidosis (after initial management) 1.
- The typical administration rate varies based on patient needs, but often ranges from 75-125 ml/hour for adults for maintenance.
- This solution should be used cautiously in patients with heart failure, kidney disease, or conditions where sodium restriction is necessary, as it still contains a significant amount of sodium.
Key Considerations
- According to the American Academy of Pediatrics, patients 28 days to 18 years of age requiring maintenance IVFs should receive isotonic solutions with appropriate KCl and dextrose because they significantly decrease the risk of developing hyponatremia 1.
- In patients at high risk for developing electrolyte abnormalities, such as those who have undergone major surgery, those in the ICU, or those with large gastrointestinal losses or receiving diuretics, frequent laboratory monitoring may be necessary.
From the Research
D5 1/2 NS IV Fluids
- D5 1/2 NS, which stands for 5% dextrose in 0.9% normal saline, is a type of intravenous (IV) fluid used for various medical purposes.
- According to a study published in 2006 2, D5 1/2 NS is often used as an initial IV replacement fluid in elective surgery.
- The study found that using D5 1/2 NS resulted in significant hyperglycemia in non-diabetic patients, with 72% of patients having plasma glucose levels exceeding 10 mmol/l after infusion.
- Another study published in 2020 3 compared the short-term metabolic effects of D5 1/2 NS, normal saline, and lactated Ringer solution in children with acute gastroenteritis.
- The study found that D5 1/2 NS had a positive effect on plasma bicarbonate levels and increased blood glucose levels compared to normal saline and lactated Ringer solution.
- A narrative review published in 2017 4 discussed the characteristics of IV fluids, including crystalloids and colloids, and their uses in maintaining hydration and treating hypovolemia.
- The review noted that IV fluids should be treated as drugs, with specific clinical indications, contraindications, and adverse effects.