 |
1 gram of Dextrose = 3.4 kcals |
|
Determine the percent of dextrose needed based on the glucose infusion
rate (estimated rate at which the liver oxidizes glucose in mgs CHO/kg/minute. |
|
Begin with a GIR of 5-6 mg/kg/minute. This is the minimum GIR
required to adequately oxygenate cerebral tissue. |
|
Advance GIR by 1-2 mg/kg/day or by 2.5% per day to goal.
Goal GIRs
| Preterm |
10-12 mg/kg/minute |
| Term |
12-14 mg/kg/minute |
|
|
Never exceed a GIR of 17 mg/kg/min |
|
Excessive glucose infusion rates or poorly tolerated GIRs can cause
fatty infiltration of the liver, cholestasis, hyperglycemia, hypertriglyceridemia,
osmotic diuresis, dehydration, respiratory distress, and metabolic abnormalities
from hyperosmotic fluids. |
|
Maximum concentration of glucose regardless of volume depends on IV
access
Maximum Glucose Concentration
| Peripheral Line |
12.5% Dextrose |
| Central Line |
20-25% Dextrose |
|
