Infusion Rate for D5NS (5% Dextrose in Normal Saline) in Adults
The typical infusion rate for D5NS in adults is 4-14 mL/kg/hour, with the specific rate depending on the patient's hydration status and corrected serum sodium. 1
Standard Administration Guidelines
- For peripheral vein administration, D5NS should be infused slowly to prevent hyperglycemia 2
- The maximum rate at which dextrose can be infused without producing glycosuria is 0.5 g/kg of body weight/hour 2
- Approximately 95% of dextrose is retained when infused at a rate of 0.8 g/kg/hour 2
- For a typical 70 kg adult, this translates to approximately 100-280 mL/hour of D5NS, adjusted based on clinical status 1
Clinical Applications and Considerations
- D5NS is particularly useful in specific clinical scenarios:
- Adrenal insufficiency: A fluid bolus of 20 mL/kg of D5NS is recommended during the first hour of treatment 3
- Diabetic ketoacidosis: D5NS should be administered once serum glucose reaches target levels, with careful monitoring of glucose and electrolytes 3
- Hypoglycemia: D5NS can be used for maintenance after initial treatment with more concentrated dextrose solutions 4
Monitoring Parameters
- Regular monitoring is essential during D5NS infusion:
Special Considerations
- In patients with renal or cardiac compromise, careful monitoring of serum osmolality and frequent assessment of cardiac, renal, and mental status must be performed to avoid iatrogenic fluid overload 1
- D5NS may cause transient hyperglycemia, even in non-diabetic patients, so glucose monitoring is important 6
- For patients requiring continuous renal replacement therapy, the D5NS infusion rate may need adjustment to prevent rapid correction of hyponatremia 7
Cautions and Contraindications
- Rapid infusion of D5NS can lead to hyperglycemia, which may be detrimental in certain conditions 6
- D5NS should be used cautiously in patients with congestive heart failure or chronic renal disease to prevent volume overload 3
- Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration 2
Pediatric Considerations
- For pediatric patients, maintenance fluid rates differ from adults:
- First 10 kg: 100 mL/kg/24 h
- 10-20 kg: 50 mL/kg/24 h
- Remaining weight: 20 mL/kg/24 h 3
Remember that while these are standard guidelines, clinical judgment is crucial in determining the appropriate infusion rate based on the patient's specific condition, comorbidities, and ongoing fluid requirements.