Carbohydrate Delivery from D5 at 65 mL/hr
A patient receiving D5 (5% dextrose) at 65 mL/hr will receive 78 grams of carbohydrates in 24 hours.
Calculation
- D5 contains 5 grams of dextrose per 100 mL 1
- At 65 mL/hr for 24 hours: 65 mL/hr × 24 hours = 1,560 mL total volume
- Total carbohydrates: (1,560 mL ÷ 100 mL) × 5 grams = 78 grams of dextrose 1
Energy Provision
- This delivers approximately 312 kcal per 24 hours (78 grams × 4 kcal/gram) 1
- This represents minimal nutritional support and is insufficient as sole nutrition 1
Clinical Context and Adequacy
This carbohydrate delivery is substantially below recommended nutritional requirements:
- Critically ill patients should receive 200-300 grams of dextrose per day as part of their nutritional regimen 1
- The 78 grams provided represents only 26-39% of recommended carbohydrate intake for nutritional support 1
- For a 70 kg patient, recommended carbohydrate intake is 3.0-3.5 g/kg/day (210-245 grams), making this infusion only about 32-37% of recommended intake 1
Insulin Coverage Considerations
If this patient has diabetes and requires insulin coverage:
- Using the guideline of 1 unit of insulin per 10-15 grams of carbohydrate, this patient would require approximately 5-8 units of insulin per 24 hours for nutritional coverage 2, 1
- This calculation assumes continuous feeding; adjustments are needed based on actual clinical scenario 2
Important Clinical Caveats
This rate is typically used for:
- Medication vehicle/dilution rather than primary nutritional support 3
- Temporary glucose provision while awaiting enteral nutrition 1
- Maintaining venous access with minimal glucose supplementation 2
Key monitoring requirements:
- Blood glucose should be monitored every 1-2 hours when administering dextrose-containing fluids 3, 4
- Thiamine should be administered prior to starting glucose infusion to reduce risk of Wernicke's encephalopathy 1, 3
Common pitfall to avoid:
- Do not rely on D5 at this rate as sole nutritional support—patients requiring nutritional support need enteral or parenteral nutrition providing 200-300 grams of carbohydrates daily 1