Carbohydrate Delivery from D5 at 100ml/hr
A patient receiving D5 (5% dextrose) at 100ml/hr will receive 120 grams of carbohydrates in 24 hours.
Calculation
- D5 contains 5 grams of dextrose per 100 mL 1
- At 100 mL/hr for 24 hours, the total volume infused is 2,400 mL 2
- Total carbohydrate delivery: (2,400 mL ÷ 100 mL) × 5 grams = 120 grams of dextrose in 24 hours 1
Clinical Context and Adequacy
This amount represents inadequate nutritional support for most patients:
- The 120 grams of dextrose provides approximately 480 kcal per 24 hours (dextrose provides ~4 kcal/gram), which is insufficient as sole nutrition 1
- Critically ill patients should receive 200-300 grams of dextrose per day as part of their nutritional regimen, making this infusion only 40-60% of recommended carbohydrate intake 1, 2
- For a 70 kg patient, recommended carbohydrate intake is 3.0-3.5 g/kg/day (210-245 grams), meaning this D5 infusion provides only about 49-57% of recommended intake 1
Insulin Coverage Considerations
- Using the guideline of 1 unit of insulin per 10-15 grams of carbohydrate, a patient with diabetes would require approximately 8-12 units of insulin per 24 hours for nutritional coverage of this dextrose load 1, 2
Important Clinical Caveats
- This rate of D5 administration is typically used for medication vehicle/dilution or temporary glucose provision while awaiting enteral nutrition, rather than primary nutritional support 2
- Blood glucose should be monitored every 1-2 hours when administering dextrose-containing fluids 2, 3
- Thiamine should be administered prior to starting glucose infusion to reduce risk of Wernicke's encephalopathy 1, 2
- Glucose-containing solutions like D5W should be avoided in acute ischemic stroke patients in the emergency department, as glucose can have detrimental effects in acute brain injury 4