From the Research
DNS (Dextrose Normal Saline) can be administered to a 5-year-old male child during episodes of dehydration, vomiting, diarrhea, or when the child needs intravenous fluid support but has normal electrolyte levels, as supported by the most recent study 1. The typical dose would be calculated based on the child's weight, with maintenance fluids generally ranging from 1000-1500 mL per day for a child this age (approximately 4-5 mL/kg/hour). Some key points to consider when administering DNS include:
- Monitoring of vital signs, urine output, and electrolyte levels is essential, as noted in various studies 2, 3, 4, 5.
- DNS should not be administered when the child has diabetic ketoacidosis, cerebral edema, hyponatremia, or fluid overload conditions like congestive heart failure.
- It's also contraindicated in cases of hyperglycemia as the dextrose component could worsen the condition.
- For prolonged fluid therapy, electrolyte monitoring becomes crucial as DNS doesn't contain potassium or other essential electrolytes that may need supplementation, as highlighted in 1. The solution works by providing both hydration through the saline component and calories through the dextrose component, making it suitable for short-term fluid replacement therapy. However, the choice of fluid should be personalized based on the child's clinical and biochemical variables, as suggested by 1. In cases of dehydration, the use of isotonic fluids like normal saline or dextrose-supplemented saline is recommended, as seen in 4. Additionally, the study 5 found that an initial intravenous bolus of 5% dextrose in normal saline solution compared with normal saline solution led to a greater reduction in serum ketone levels in children with gastroenteritis and dehydration. Overall, the administration of DNS should be guided by the child's specific needs and clinical condition, with careful monitoring and adjustment as necessary.