From the Guidelines
D5W (5% Dextrose in Water) is used for hypernatremia.
Rationale
- The use of D5W in hypernatremia is supported by the fact that it provides free water, which is essential for correcting the water deficit and reducing serum sodium levels 1.
- D5W is recommended for intravenous rehydration in patients with hypernatremic dehydration, as it delivers no renal osmotic load and allows for a slow decrease in plasma osmolality 1.
- The administration of D5W should be calculated based on physiological demand, and the routine maintenance rate can be used as a starting volume 1.
- It is essential to note that D5W should not be administered as a bolus due to the risk of rapid decrease in serum sodium, which can lead to brain edema 1.
- Isotonic fluids, such as NaCl 0.9% solutions, should be avoided in hypernatremic dehydration due to their high renal osmotic load, which can exacerbate hypernatremia 1.
From the Research
D5W (5% Dextrose in Water) Use in Hypernatremia
- D5W is used to treat hypernatremia, as it provides free water to help correct the sodium imbalance 2, 3, 4.
- The use of D5W in hypernatremia is supported by studies that show its effectiveness in lowering serum sodium levels 2.
- In one study, parenteral D5W was found to be slightly more effective than enteral free water in lowering serum sodium levels in patients with ICU-acquired hypernatremia 2.
- D5W can be used in combination with other treatments, such as hypotonic saline solution, to correct hypernatremia 5, 3.
- The calculation of fluid volume needed to correct hypernatremia can be obtained using various formulae, and D5W can be used to provide the necessary free water 5.
Treatment of Hypernatremia
- Hypernatremia is typically treated with free water administration, either enterally or parenterally 5, 2.
- The speed of correction is important, as too rapid correction of chronic hypernatremia can result in brain edema 5.
- D5W can be used to provide free water and help correct hypernatremia, especially in patients who require parenteral nutrition or have limited oral intake 2, 3, 4.
Specific Studies
- A retrospective cohort study found that parenteral D5W was effective in treating ICU-acquired hypernatremia, with a significant decrease in serum sodium levels 2.
- A case report described the use of 0.2% sodium chloride in 5% dextrose in water to treat hypernatremia in a patient with hyperosmolar hyperglycemic syndrome, resulting in amelioration of neurological symptoms 3.
- A case study described the development of hyponatremia and then hypernatremia in a patient receiving total parenteral nutrition, highlighting the importance of monitoring sodium levels and adjusting fluid intake accordingly 4.