Is D5 (dextrose 5%) water used through a nasogastric (NG) tube?

D5 Water Through Nasogastric Tubes: Not Standard Practice

D5 water (5% dextrose in water) is not routinely used through nasogastric tubes for enteral feeding—NG tubes are designed for nutritional support using specialized enteral formulas, not simple dextrose solutions. 1

Why NG Tubes Are Not Used for D5 Water

Primary Purpose of NG Tubes

• NG tubes are specifically intended for enteral tube feeding (ETF) using complete nutritional formulas that provide calories, protein, vitamins, and minerals—not simple sugar water 1
• Fine bore (5-8 French gauge) NG tubes should be used for ETF with standard enteral feeds, and most fiber-enriched feeds can be administered through these tubes 1
• The stomach permits use of hypertonic feeds, higher feeding rates, and bolus feeding when delivered via NG tube 1

D5 Water Is an IV Solution, Not Enteral Nutrition

• D5 water contains only 50 grams of dextrose per liter with no protein, fat, electrolytes, or other nutrients—it provides inadequate nutrition for patients requiring tube feeding 2, 3
• D5-containing IV fluids are designed for intravenous administration in specific clinical scenarios like DKA management (when glucose drops to 250 mg/dL), hypernatremic dehydration correction, or pediatric maintenance fluids 2
• Using D5 water through an NG tube would fail to meet nutritional requirements and could lead to malnutrition 1

When Dextrose Solutions Are Appropriate

Intravenous Route Only

• D5 normal saline or D5 water should be given intravenously, not enterally, for patients who cannot self-regulate fluid intake and must fast >4 hours 2
• For DKA, switch to D5 or D10 with 0.45-0.75% NaCl intravenously when serum glucose reaches 250 mg/dL 2
• Pediatric patients at risk for hypoglycemia benefit from D10 normal saline IV to meet glucose requirements of 4-6 mg/kg/min 2

Critical Pitfall to Avoid

• Administering D5 water through an NG tube instead of proper enteral nutrition would constitute medical negligence—patients requiring NG feeding need complete nutritional support, not just glucose 1
• If a patient needs both hydration and nutrition, use appropriate enteral formulas through the NG tube (typically 30 ml/kg/day of standard 1 kcal/ml feed) and supplement with IV fluids if needed 1

Proper NG Tube Management

What Should Go Through NG Tubes

• Standard enteral feeding formulas prescribed by dietitians or nutrition experts based on patient needs 1
• Medications that can be safely administered enterally (with appropriate flushing using 30 mL water before and after) 4
• Position must be verified using pH testing prior to every use 1

Monitoring Requirements

• Common complications include tube dislodgement (48.5%), electrolyte alterations (45.5%), hyperglycemia from enteral feeds (34.5%), and diarrhea (32.8%) 5
• Gastric residual volume should be checked periodically, with most nurses withholding feeds at volumes <300 mL due to aspiration risk 6