Total Carbohydrate Calculation for D5 at 55 mL/hr
A patient receiving D5 (5% dextrose) at 55 mL/hr over 24 hours will receive 66 grams of carbohydrates total.
Calculation Method
- D5 contains 5 grams of dextrose per 100 mL of solution 1
- At an infusion rate of 55 mL/hr, the total volume over 24 hours = 55 mL/hr × 24 hours = 1,320 mL
- Total carbohydrate delivery = (1,320 mL ÷ 100 mL) × 5 grams = 66 grams over 24 hours
- This translates to approximately 2.75 grams per hour 1
Clinical Context and Adequacy
This carbohydrate load is insufficient as sole nutritional support and represents minimal glucose provision.
- The 66 grams of dextrose provides approximately 264 kcal of energy (dextrose provides ~4 kcal/gram), which is grossly inadequate for nutritional support 1
- For comparison, critically ill patients in the Van den Berghe trials received 200-300 grams of dextrose per day as part of their nutritional regimen 2
- Standard parenteral nutrition recommendations suggest 3.0-3.5 g/kg body weight/day of glucose (approximately 210-245 grams for a 70 kg patient), making this D5 infusion only about 27-31% of recommended carbohydrate intake 3
Insulin Coverage Considerations
- If this patient is diabetic and receiving insulin coverage, approximately 4-7 units of insulin per 24 hours would be needed for nutritional coverage (using the guideline of 1 unit per 10-15 grams of carbohydrate) 1
- This minimal carbohydrate load may be insufficient to prevent hypoglycemia in patients receiving basal insulin, particularly type 1 diabetics 4
Common Clinical Scenarios
This rate is typically used for:
- Maintenance of IV access with minimal glucose supplementation
- Prevention of ketosis in patients who cannot take oral nutrition for short periods
- Temporary glucose provision while awaiting enteral nutrition initiation
This rate is NOT appropriate for: