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Intravenous Dextrose
Aka: Intravenous Dextrose
- Indications
- Hypoglycemia by rapid bedside Glucometer
- Child who fails to respond to Resuscitation
- Physiology
- Ill children deplete glycogen stores rapidly
- Hypoglycemia depresses neonatal myocardial function
- Effects of Glucose on brain
- Ischemic Neonatal brain
- May benefit from Glucose
- Mature Child brain
- Poor neurologic outcome with Glucose
- Dosing
- See dosing by the rule of 50 below
- Dextrose 12.5% (D12.5W): 1:3 dilution of D50W in water
- Newborn: 0.5-1.0 g/kg (4-8 ml/kg) D12.5W IV or IO
- Dextrose 25% (D25W): 1:1 dilution of D50W in water
- Children: 0.5-1.0 g/kg (2-4 ml/kg) D25W IV or IO
- Do not use in newborns!
- Dextrose 50% (D50)
- Use exclusively in adults at 1 ml/kg
- Dosing: Rule of 50
- Divide 50 by the type of dextrose solution to arrive at rate in ml/kg
- Adult (D50): 50/50 = 1 ml/kg
- Child (D25): 50/25 = 2 ml/kg
- Infant (D10): 50/10 = 5 ml/kg
- Dosing
- Adult: D50 at 1 ml/kg
- Child: D25 at 2 ml/kg
- Infant: D10 at 5 ml/kg
- Precautions
- Peripheral vein sclerosis
- Occurs with concentrated Dextrose (D25)
- Poor outcomes related to repeated Glucose bolus in:
- Severe Head Injury (poor neurologic outcome)
- Submersion
- Hypovolemic Shock