Is 10% dextrose (D10) at 75cc/hr a safe infusion rate?

Safety of D10 at 75cc/hr Infusion Rate

D10 at 75cc/hr is a safe infusion rate for most patients, as it provides approximately 7.5g of glucose per hour, which falls within recommended maintenance glucose delivery rates. 1

Glucose Delivery Calculations and Safety Parameters

• D10 contains 10g of glucose per 100ml of solution 1
• At 75cc/hr, this provides 7.5g of glucose per hour (10g × 0.75) 1
• Pediatric guidelines recommend maintenance glucose delivery rates of 7mg/kg/min, which this rate would satisfy for patients weighing approximately 18kg 1
• For adults, this rate provides adequate glucose supplementation without risking hyperglycemia 1

Clinical Applications and Benefits

• This infusion rate is commonly used in:

  • Maintenance fluid therapy when glucose supplementation is needed 1
  • Preventing hypoglycemia during insulin therapy for hyperkalemia 2
  • Treatment of hypoglycemia with a more controlled approach than D50 boluses 3, 4

• D10 at this rate offers several advantages over higher concentration solutions:

  • Less risk of extravasation injury compared to D50 4
  • More physiologic correction of blood glucose levels 3, 5
  • Lower post-treatment hyperglycemia risk 3, 5

Monitoring Recommendations

• For patients receiving D10 at 75cc/hr:
  • Monitor blood glucose every 2 hours if stable, or hourly after any change in infusion rate 1
  • Check glucose within 15-30 minutes if hypoglycemia is suspected 1
  • Monitor potassium levels every 4 hours if stable 1
  • Titrate the rate based on blood glucose levels to maintain normoglycemia 1

Special Considerations and Precautions

• Patients with fluid restrictions may require more concentrated dextrose solutions 1
• Patients with diabetes may need concurrent insulin therapy when receiving D10 infusions 1
• Hyperglycemia can have adverse central nervous system effects, so glucose levels should be maintained in the normal range 1
• Patients with liver failure may require higher glucose infusion rates (up to 16 mg/kg/min) 1

Comparison to Alternative Concentrations

• D10 is generally preferred over D50 for continuous infusions because:

  • D50 is more irritating to veins 1
  • D10 results in more stable glucose levels with fewer hyperglycemic excursions 3, 5
  • D10 has fewer reported adverse events in comparative studies 3, 4

• When treating hypoglycemia, D10 may take slightly longer to correct (approximately 8 minutes vs. 4 minutes for D50), but provides more physiologic correction 5