What does the order 'D5' specify, is it Dextrose (D5) 5% in water or Dextrose (D5) 5% with Sodium Chloride (NaCl) 0.45%?

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From the Guidelines

D5 specifically refers to Dextrose 5% in water, which is a solution containing 5 grams of dextrose (glucose) per 100 mL of water, without sodium chloride. The order 'D5' does not imply the presence of sodium chloride, and if sodium chloride were included, the order would explicitly state this, such as "D5 0.45% NaCl" or "D5 1/2NS" 1. Key points to consider when administering D5 include:

  • D5W (Dextrose 5% in Water) is an isotonic solution when first administered, but becomes hypotonic as the dextrose is metabolized, leaving free water.
  • It's commonly used for hydration, as a vehicle for medication administration, and to provide a small amount of calories (170 calories per liter).
  • Healthcare providers should be aware that D5W contains no electrolytes, so it's not appropriate for replacing electrolyte losses or for long-term maintenance fluids without supplementation.
  • When administering D5, monitor for signs of fluid overload, hyperglycemia, and electrolyte imbalances, especially in patients with cardiac, renal, or endocrine disorders, as noted in the management of hyperglycemic crises in patients with diabetes mellitus 1. In clinical practice, the specific composition of IV fluids, such as D5, is crucial for patient management, particularly in conditions like diabetic ketoacidosis, where fluid and electrolyte balance is critical 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Order Specification

The order 'D5' typically specifies Dextrose 5% in water, which is often abbreviated as D5W.

  • D5W is a solution of 5% dextrose in water, with no added sodium chloride 2, 3, 4.
  • There is no evidence to suggest that 'D5' inherently includes sodium chloride 0.45% 2, 3, 4, 5, 6.
  • Studies have compared the effects of D5W with other solutions, such as 0.45% saline and 0.9% saline, in various medical contexts 5, 6.

Composition of D5W

  • D5W is composed of 5% dextrose in water, with no added electrolytes 2, 3, 4.
  • The solution has a specific gravity and osmolality that can affect its use in medical treatments 5, 6.
  • D5W can be used as a drug diluent or for other medical purposes, but its composition and effects should be carefully considered 4.

Comparison with Other Solutions

  • Studies have compared D5W with other solutions, such as 0.45% saline and 0.9% saline, in terms of their effects on blood chemistry and medical outcomes 5, 6.
  • The choice of solution can depend on the specific medical context and the needs of the patient 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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