Endocrinology Book

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Intravenous Dextrose

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  1. Indications
    1. Hypoglycemia by rapid bedside Glucometer
    2. Child who fails to respond to Resuscitation
  2. Physiology
    1. Ill children deplete glycogen stores rapidly
    2. Hypoglycemia depresses neonatal myocardial function
    3. Effects of Glucose on brain
      1. Ischemic Neonatal brain
        1. May benefit from glucose
      2. Mature Child brain
        1. Poor neurologic outcome with glucose
  3. Dosing
    1. Dextrose 12.5% (D12.5W): 1:3 dilution of D50W in water
      1. Newborn: 0.5-1.0 g/kg (4-8 ml/kg) D12.5W IV or IO
    2. Dextrose 25% (D25W): 1:1 dilution of D50W in water
      1. Children: 0.5-1.0 g/kg (2-4 ml/kg) D25W IV or IO
      2. Do not use in newborns!
  4. Precautions
    1. Peripheral vein sclerosis
      1. Occurs with concentrated Dextrose (D25)
    2. Poor outcomes related to repeated glucose bolus in:
      1. Severe Head Injury (poor neurologic outcome)
      2. Submersion
      3. Hypovolemic Shock

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