Recommended D5W Continuous Infusion Rate
For maintenance glucose support in adults, infuse D5W at approximately 100 mL/hour, which delivers about 5 grams of dextrose per hour and prevents hypoglycemia while avoiding hyperglycemia. 1
Standard Maintenance Dosing
The typical maintenance infusion rate for D5W is 100 mL/kg per 24 hours, translating to roughly 100 mL/hour for an average 70 kg adult. 1
This rate provides sufficient glucose to maintain blood glucose levels without causing hyperglycemia in non-diabetic patients. 1
Clinical Context Adjustments
Hypoglycemia Management
- After initial correction of acute hypoglycemia with concentrated dextrose boluses, continuous D5W at 100 mL/hour prevents recurrent hypoglycemia. 1
Diabetic Ketoacidosis
- Once serum glucose reaches 200-250 mg/dL during DKA treatment, switch to D5W-containing fluids at 4-14 mL/kg/hour (approximately 280-980 mL/hour for a 70 kg adult) to maintain glucose in target range while continuing insulin therapy. 1
- This prevents hypoglycemia while resolving ketoacidosis. 1
Adrenal Insufficiency
- After initial fluid bolus of 20 mL/kg of D5NS over the first hour, maintain at 100-150 mL/hour. 1
Pediatric Weight-Based Calculations
Critical Monitoring Requirements
Monitor blood glucose every 1-2 hours when initiating D5W infusions to ensure the rate is appropriate for the individual patient. 1
In patients with cardiac or renal compromise, limit D5W rates to 100 mL/hour or less and monitor closely for fluid overload. 1
Important Caveats When D5W Serves as Drug Diluent
When D5W is used as a vehicle for medication infusions rather than for glucose maintenance, the infusion rate is determined by the medication dosing requirements, not glucose needs:
Epinephrine infusions: 1 mg in 250 mL D5W at 1-4 mcg/min (15-60 drops/min with microdrop apparatus), up to maximum 10 mcg/min for adults. 2
Prostaglandin E1 (for ductal-dependent cardiac lesions): 0.05-0.10 mcg/kg/min infusion in D5W. 2
Morphine: 0.15-0.25 mg/kg per dose infused over 10 minutes in D5W. 2
In these scenarios, monitor blood glucose levels regardless of infusion rate, especially in diabetic patients. 3