How many carbohydrates does a patient receive in a 24-hour period when administered 5% dextrose (D5) at 150 milliliters per hour?

Carbohydrate Delivery from D5 at 150 mL/hr

A patient receiving D5 (5% dextrose) at 150 mL/hr will receive 180 grams of carbohydrates in a 24-hour period.

Calculation

• D5 contains 5 grams of dextrose per 100 mL 1
• At 150 mL/hr × 24 hours = 3,600 mL total volume per day
• 3,600 mL ÷ 100 mL = 36 units of 100 mL
• 36 × 5 grams = 180 grams of dextrose (carbohydrates) per 24 hours

Clinical Context and Energy Provision

• This delivers approximately 720 kcal of energy per day (dextrose provides ~4 kcal/gram), which represents partial nutritional support but is insufficient as sole nutrition 1
• This carbohydrate load is appropriate for preventing hypoglycemia in patients who must abstain from food, as 2-3 g/kg/day of dextrose can be used for short-term glucose provision when patients cannot eat for more than 12 hours 1

Important Clinical Considerations

For Diabetic Patients

• Patients receiving 180 grams of carbohydrates per 24 hours would require approximately 12-18 units of insulin for nutritional coverage (using the guideline of 1 unit insulin per 10-15 grams of carbohydrate) 1
• Blood glucose monitoring every 1-2 hours is essential when administering dextrose-containing fluids to avoid both hypoglycemia and hyperglycemia 1, 2

Safety Monitoring

• Regular blood glucose monitoring is critical to prevent complications 1
• Thiamine should be administered prior to starting glucose infusion to reduce the risk of Wernicke's encephalopathy when using dextrose as part of nutritional support 1

Specific Clinical Scenarios

• In nephrogenic diabetes insipidus, D5 delivers no renal osmotic load, making it preferable to salt-containing solutions which can worsen hypernatremia 3
• For medication dilution (such as amphotericin B), D5 is commonly used as the vehicle, typically in 200 mL volumes 3