How many calories does a patient receive from a 500 mL infusion of 5% dextrose in normal saline (DNS)?

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Caloric Content of 500 mL DNS (5% Dextrose in Normal Saline)

A 500 mL infusion of 5% dextrose in normal saline (DNS) provides approximately 85 kilocalories to the patient.

Calculation Breakdown

  • DNS contains 5 grams of dextrose per 100 mL, meaning 500 mL contains 25 grams of dextrose 1
  • Dextrose provides approximately 3.4 kcal/gram when administered intravenously as a monohydrate 2
  • Total caloric content: 25 grams × 3.4 kcal/gram = 85 kcal from the 500 mL DNS infusion 2

Clinical Context and Adequacy

  • This 85 kcal represents minimal nutritional support and is insufficient as sole nutrition for any patient population 1
  • For a 70 kg patient, recommended carbohydrate intake is 210-245 grams per day (3.0-3.5 g/kg/day), meaning this single 500 mL bag provides only about 10-12% of daily carbohydrate requirements 1
  • Critically ill patients should receive 200-300 grams of dextrose per day as part of their nutritional regimen, making a single 500 mL DNS bag provide only 8-12% of recommended daily dextrose 1

Important Clinical Caveats

  • DNS is primarily used for fluid resuscitation and medication delivery, not as a primary nutritional source 2
  • The normal saline component provides no calories—only the dextrose portion contributes to caloric intake 3
  • For patients requiring nutritional support, total parenteral nutrition (TPN) should provide 25-30 kcal/kg/day based on ideal body weight, which would be 1,750-2,100 kcal/day for a 70 kg patient 2
  • In malnourished patients, thiamine must be administered before any glucose infusion to prevent precipitating Wernicke's encephalopathy 4

When DNS Caloric Content Matters

  • Non-nutritional calories from dextrose infusions can contribute to overfeeding when combined with enteral or parenteral nutrition, particularly during the first days of ICU admission when the proportion may reach 30-36% of total intake 5
  • Blood glucose monitoring is essential as even 500 mL of DNS can cause transient hyperglycemia, with 72% of patients exceeding 10 mmol/L plasma glucose after infusion 6
  • DNS should be added as maintenance fluid with Ringer's lactate in burn resuscitation to provide both sodium and glucose content that RL alone cannot supply 3

References

1
Guideline

Dextrose Administration Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

2
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Research

New fluid therapy protocol in acute burn from a tertiary burn care centre.

Burns : journal of the International Society for Burn Injuries, 2019

4
Guideline

D5 Administration in Malnourished Patients

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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