Intravenous sugar solution

An intravenous sugar solution is a solution with a sugar (usually glucose, as known as dextrose, with water as the solvent) used for intravenous therapy, where it may function both as a means of maintaining tissue hydration and a means of parenteral nutrition. Most IV sugar solutions are crystalloid solutions.

Types

Types of glucose/dextrose include:

• D5W (5% dextrose in water), which consists of 278 mmol/L dextrose
• D5NS (5% dextrose in normal saline), which, in addition, contains normal saline (0.90% w/v of NaCl).
  • D5 1/2NS 5% dextrose in half amount of normal saline (0.45% w/v of NaCl).^[1]
• D5LR (5% dextrose in lactated Ringer solution)

The percentage is a mass percentage, so a 5% glucose/dextrose solution contains 50 g/L of glucose/dextrose (Quite simply, 5% dextrose means the solution contains 5g/100ml of solution).

Glucose provides energy 4 kcal/gram, so a 5% glucose solution provides 0.2 kcal/ml. If prepared from dextrose monohydrate, which provides 3.4 kcal/gram, a 5% solution provides 0.17 kcal/ml.^[2]

Indications

Administering a 5% sugar solution peri- and postoperatively usually achieves a good balance between starvation reactions and hyperglycemia caused by sympathetic activation. A 10% solution may be more appropriate when the stress response from the reaction has decreased, after approximately one day after surgery. After more than approximately 2 days, a more complete regimen of total parenteral nutrition is indicated.

In patients with hypernatremia and euvolemia, free water can be replaced using either 5% D/W or 0.45% saline.

In patients with fatty-acid oxidation disorders (FOD), 10% solution may be appropriate upon arrival to the emergency room.

Dangers

Intravenous glucose is used in some Asian countries a pick-me-up, for "energy," but is not a part of routine medical care in the United States where a glucose solution is a prescription drug. Asian immigrants to the United States are at risk if they seek intravenous glucose treatment. It may be had at store-front clinics catering to Asian immigrants, but, despite having no more effect than drinking sugared water, poses medical risks such as the possibility of infection. It is commonly called "ringer."^[3]

See also

• Parenteral nutrition

References

1. eMedicine > Hypernatremia: Treatment & Medication By Ivo Lukitsch and Trung Q Pham. Updated: Apr 19, 2010
2. Calculating Parenteral Feedings D. Chen-Maynard at California State University, San Bernardino. Retrieved September 2010. HSCI 368
3. Jiha Ham (March 20, 2015). "A Life Upended After an IV Glucose Treatment Popular Among Asian Immigrants". The New York Times. Retrieved March 21, 2015. Although many doctors warn Asian immigrants in New York that the effects of injecting glucose differ little from drinking sugary water, many Asians, especially of older generations, still use the intravenous solution. In their homelands, it is commonly prescribed by doctors as a method to cure colds, fevers and sometimes an upset stomach.