Ever wondered how much in each one ml of 10% Dextrose Water? Do you give IV D10W to neonates? Here is some numbers that can help.
By convention when we say 10% Dextrose, this means there is 10 Grams of Glucose in each 100 ml of water. This translates to 100 mg of glucose in each milliliter (ml) of D10W.
The IV Bolus in emergency situations is 0.2 to 0.3 Grams of glucose per kilogram and so we now know this means it’s 2-3 ml/kg of D10, give slowly (2 min) because rapid increase will biget a decrease in glucose level due to insulin secretion.
While if you are going to use D10 for IV maintenance fluid therapy and If there is no hypoglycemia you can start with 65-80 ml/kg/day just like a regular day 1 neonate total fluid volume. If there is hypoglycemia it is recommended to start with 100-120 ml/kg/day.
Glucagon dose (if you could not get IV) is 0.03 mg/kg with maximum 1 mg
To calculate the GIR (Glucose Infusion Rate) which is in (mg/kg/min) you use this formula:
Percent glucose in the bag X 10 X you current infusion rate (ml/hr) divided by 60 X Weight in kg
If your GIR approaches 12 mg/kg/min then think hyperinsulinism and it’s not just your everyday neonatal hypoglycemia.