Recommended Infusion Rate for Dextrose 5% in Normal Saline
The recommended infusion rate for Dextrose 5% in Normal Saline is 0.5 g/kg of body weight per hour, which is the maximum rate at which dextrose can be infused without producing glycosuria. 1
Administration Guidelines
- For peripheral vein administration, the injection of Dextrose 5% in Normal Saline should be made slowly to avoid complications 1
- Approximately 95% of the dextrose is retained when infused at a rate of 0.8 g/kg/hour, though this exceeds the recommended maximum rate 1
- For central venous administration as part of total parenteral nutrition, the solution should be administered via an indwelling catheter with the tip positioned in a large central vein, preferably the superior vena cava 1
Specific Patient Populations
Adults
- For fluid resuscitation in adults, 1-2 L of normal saline might need to be administered at a rate of 5-10 mL/kg in the first 5 minutes 2
- For maintenance fluid therapy in adults, the recommended rate is 25-30 mL/kg/24 hours 2
Children
- Children should receive up to 30 mL/kg in the first hour for fluid resuscitation 2
- For maintenance fluid therapy in children, the recommended rates are 2:
- First 10 kg: 100 mL/kg/24 hours
- 10-20 kg: 50 mL/kg/24 hours
- Remaining weight: 20 mL/kg/24 hours
Clinical Considerations
- Dextrose 5% in Normal Saline should be inspected visually for particulate matter and discoloration prior to administration 1
- Regular monitoring of blood glucose levels is essential when administering dextrose-containing fluids to avoid both hypoglycemia and hyperglycemia 3
- In patients with renal impairment or heart failure, careful monitoring is required as large volumes may lead to volume overload 2
Potential Complications
- Rapid administration of concentrated dextrose solutions can lead to complications including hyperglycemia 4
- A study showed that even a relatively small volume of 500 mL of dextrose-containing solution can cause significant, albeit transient, hyperglycemia in non-diabetic patients 4
- In patients with head trauma, hypoosmolar IV fluids should be avoided as they can worsen cerebral edema 5
Alternative Applications
- For treatment of hypoglycemia, intravenous injection of 10-25 grams of dextrose is usually adequate 1
- For short-term glucose provision when patients must abstain from food for more than 12 hours, 2-3 g/kg/day of dextrose can be used 3
Remember that clinical evaluation and periodic laboratory determinations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid-base balance during prolonged parenteral therapy 1.