From the Guidelines
Normal saline (NS) with 10% glucose IV fluid should be used in patients with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) who require both fluid resuscitation and glucose supplementation, as well as in patients who are at risk for hypoglycemia and need maintenance fluids with glucose support 1. When considering the use of NS with 10% glucose IV fluid, it's essential to evaluate the patient's hydration status, electrolyte balance, and glucose levels. This combination is particularly valuable for patients experiencing hypoglycemia alongside dehydration or electrolyte imbalances, such as in diabetic patients with hypoglycemia who also need volume replacement.
- The solution provides sodium chloride (154 mEq/L of each) for electrolyte replacement while the 10% glucose (100 g/L) helps prevent hypoglycemia and provides some caloric intake.
- The standard administration rate varies based on the clinical situation, typically ranging from maintenance rates (1-4 mL/kg/hr) to higher rates for active resuscitation.
- However, this combination should be used cautiously in patients with heart failure, renal failure, or conditions where sodium or fluid overload is a concern, as the sodium content is significant.
- Blood glucose levels should be monitored regularly during administration to prevent hyperglycemia, especially in diabetic patients. In contrast to other studies that have investigated the use of aggressive intravenous hydration in acute pancreatitis 1, the use of NS with 10% glucose IV fluid is more relevant to the management of DKA and HHS, where both fluid resuscitation and glucose supplementation are crucial.
- The guidelines for the management of DKA and HHS emphasize the importance of fluid replacement, electrolyte management, and glucose control 1.
- The use of NS with 10% glucose IV fluid can help achieve these goals, but it's essential to monitor the patient's response closely and adjust the treatment plan as needed.
From the Research
NS + 10% Glucose IV Fluid Usage
- NS + 10% glucose iv fluid is used in specific medical situations, although the provided studies do not directly address its usage.
- The studies focus on comparisons between different types of IV fluids, such as normal saline, lactated Ringer's, and dextrose-containing solutions, in various medical contexts, including elective surgery 2, acute burns 3, labor induction 4, and diabetic surgical patients 5.
- In the context of acute burns, a study suggests that using a combination of Ringer's lactate and dextrose normal saline (DNS) as maintenance fluid can help maintain sodium and glucose levels within a normal range 3.
- However, none of the studies directly discuss the use of NS + 10% glucose iv fluid, making it challenging to provide a specific answer based on the available evidence.
- Further research or clinical guidelines may be necessary to determine the appropriate usage of NS + 10% glucose iv fluid in medical practice.