Dextrose (5%) Pediatric Dose — Hypoglycemia Resuscitation
Dextrose is a rapidly acting carbohydrate that corrects hypoglycemia by directly supplying glucose to the bloodstream. In pediatric resuscitation, dextrose 5% (D5W) is used to restore euglycemia in neonates and children with documented or clinically suspected hypoglycemia. Prompt treatment is essential to prevent neurological injury associated with prolonged low blood glucose.
Pediatric Dosing
The recommended IV dose of dextrose (5%) for hypoglycemia is 0.5–1 g/kg. Because dextrose 5% contains 50 mg of dextrose per mL (0.05 g/mL), the corresponding volume is 10–20 mL/kg of D5W.
- Dose: 0.5–1 g/kg IV
- Concentration used: Dextrose 5% (D5W) — 0.05 g/mL
- Equivalent volume: 10–20 mL/kg IV
Worked example: For a 10 kg child: 10 kg × 0.5–1 g/kg = 5–10 g total, which equals 100–200 mL of D5W. Consult institutional protocol for maximum single-dose volume and repeat dosing intervals.
Indications and Clinical Context
Dextrose 5% IV is indicated for the acute management of symptomatic or documented hypoglycemia in pediatric patients, including neonates, infants, and children. Hypoglycemia in the resuscitation setting may result from prolonged fasting, sepsis, metabolic disorders, or insulin excess, and represents a rapidly reversible cause of altered mental status and seizures.
In the context of pediatric resuscitation and PALS-aligned care, blood glucose should be checked early and treated promptly when levels fall below age-appropriate thresholds. Dextrose 5% is a lower-concentration option appropriate for neonates and small infants, where higher-concentration dextrose solutions carry a risk of osmotic injury and hyperglycemia if administered too rapidly.
Administration and Monitoring
Administer dextrose 5% via a secure IV or intraosseous (IO) line. Deliver the calculated volume as a slow IV push or short infusion, avoiding rapid boluses that may cause rebound hypoglycemia or osmotic shifts. Confirm adequate venous access prior to administration, as dextrose solutions are hyperosmolar compared to plasma and may cause local tissue injury if extravasation occurs.
- Recheck blood glucose 15–30 minutes after administration to assess response.
- Monitor for rebound hypoglycemia and repeat dosing as needed per clinical response.
- Monitor for hyperglycemia, particularly in critically ill or neonatal patients.
- Consult institutional protocol for maximum dosing volumes and use in neonates with restricted fluid requirements.
Disclaimer: This article is an educational reference summarizing standard pediatric dosing values. It is not a substitute for clinical judgment. Always verify doses against institutional protocols, the current edition of authoritative references (e.g., Lexicomp, Harriet Lane Handbook, PALS guidelines), the patient’s accurate weight, and any patient-specific factors (renal/hepatic function, allergies, comedications) before administration.