Glucose Administration Rate Calculation
The glucose administration rate for this 2.58 kg neonate receiving 10% Dextrose at 2 ml/hr and Term Formula at 7.5 ml/hr is 6.8 mg/kg/min, which falls within the recommended target range of 5-10 mg/kg/min for term neonates beyond day 1 of life. 1
Step-by-Step Calculation
From 10% Dextrose IV Solution
- Glucose concentration: 10% dextrose = 100 mg/ml 1
- Infusion rate: 2 ml/hr
- Glucose delivery per hour: 2 ml/hr × 100 mg/ml = 200 mg/hr 1
- Glucose delivery per minute: 200 mg/hr ÷ 60 min = 3.33 mg/min 1
- Glucose per kg per minute: 3.33 mg/min ÷ 2.58 kg = 1.29 mg/kg/min 1
From Term Formula
- Carbohydrate content: Standard term formula contains approximately 6.7 g/100 ml (or 67 mg/ml) 1
- Infusion rate: 7.5 ml/hr
- Glucose delivery per hour: 7.5 ml/hr × 67 mg/ml = 502.5 mg/hr 1
- Glucose delivery per minute: 502.5 mg/hr ÷ 60 min = 8.38 mg/min 1
- Glucose per kg per minute: 8.38 mg/min ÷ 2.58 kg = 3.25 mg/kg/min 1
Total Glucose Administration Rate
- Combined rate: 1.29 + 3.25 = 6.8 mg/kg/min 1
Clinical Context and Appropriateness
This calculated rate of 6.8 mg/kg/min is appropriate for a term neonate beyond day 1 of life, as it falls within the recommended target range of 5-10 mg/kg/min (maximum 12 mg/kg/min). 2, 1
Target Glucose Parameters
- The goal is to maintain blood glucose levels between 3.5-5.5 mmol/L (63-99 mg/dL) after 72 hours of life 1
- Avoid hyperglycemia >8 mmol/L (145 mg/dL) and hypoglycemia <2.5 mmol/L (45 mg/dL) 1
- For term newborns on day 2 onwards, the target parenteral glucose supply is 5-10 mg/kg/min (7.2-14.4 g/kg/day), with a minimum of 2.5 mg/kg/min and maximum of 12 mg/kg/min 2
Critical Pitfalls to Avoid
Failing to account for all sources of glucose (including formula feeds, medications, or other IV fluids) when calculating total glucose load can lead to inaccurate assessments and potential hyperglycemia or hypoglycemia 1
Excessive glucose administration can cause hyperglycemia, increased lipogenesis, hepatic steatosis, and increased CO2 production 1
Inadequate glucose delivery risks hypoglycemia, which can impair neurodevelopment in neonates 1
Using point-of-care glucometers instead of validated laboratory equipment for critical glucose monitoring can result in inaccurate blood glucose measurements 1
Monitoring Recommendations
- Monitor blood glucose concentrations regularly to ensure levels remain within target range 2, 1
- Maintain glucose infusion rates constant during any blood transfusions to prevent hypoglycemia 2
- In acute illness such as infection or sepsis, glucose requirements may need temporary reduction with closer monitoring 2