Is D10 Hypertonic?
Yes, D10 (10% dextrose solution) is hypertonic with an osmolarity of 3424 mOsm/L, significantly higher than physiological osmolarity of approximately 290 mOsm/L. 1
Understanding Tonicity of Dextrose Solutions
Tonicity is determined by comparing a solution's osmolarity to that of normal body fluids:
- Isotonic solutions: ~290 mOsm/L (similar to body fluids)
- Hypertonic solutions: >290 mOsm/L (higher than body fluids)
- Hypotonic solutions: <290 mOsm/L (lower than body fluids)
According to the physicochemical properties of various solutions documented in clinical guidelines:
| Solution | Osmolarity (mOsm/L) | Classification |
|---|---|---|
| 0.9% normal saline | 308 | Slightly hypertonic |
| 10% dextrose (D10) | 3424 | Highly hypertonic |
| 3% saline | 1026 | Hypertonic |
Clinical Implications of D10's Hypertonicity
The hypertonicity of D10 has important clinical implications:
Osmotic Effect: D10 creates a significant osmotic gradient that pulls fluid from intracellular to extracellular spaces 1
Vascular Access Considerations: Due to its hypertonicity, D10 should be administered through a secure intravenous line to prevent extravasation injuries
Clinical Applications: The hypertonic nature of D10 makes it useful in specific clinical scenarios:
Monitoring Requirements: When administering hypertonic solutions like D10, careful monitoring is required to prevent rapid changes in serum osmolality 5
Comparison with Other Dextrose Concentrations
D10 is less hypertonic than higher concentration dextrose solutions like D50, which has practical advantages:
- Lower post-treatment blood glucose levels (6.2 mmol/L vs 8.5 mmol/L with D50) 2
- Fewer adverse events compared to D50 2, 3
- Similar efficacy in treating hypoglycemia with potentially better safety profile 4
Important Considerations When Using D10
When using D10, clinicians should be aware that:
- It is specifically listed in pediatric emergency guidelines as an essential medication 1
- It may require slightly longer time to achieve clinical effect compared to D50 but with fewer adverse events 2, 3
- It can be administered in 5g (50mL) aliquots for treating hypoglycemia 3
- It has demonstrated efficacy and safety in prehospital settings 6
In conclusion, D10 is definitively a hypertonic solution with an osmolarity of 3424 mOsm/L, more than 10 times the osmolarity of normal body fluids. This property makes it clinically useful but requires appropriate administration and monitoring.