Carbohydrate Delivery and Nutritional Support

Calculation and Energy Provision

A patient receiving D5 at 65 mL/hr will receive 78 grams of carbohydrates in 24 hours, delivering approximately 312 kcal per 24 hours, which is insufficient as sole nutrition, according to the American College of Nutrition 1
The total volume of D5 administered at 65 mL/hr for 24 hours is 1,560 mL, containing 5 grams of dextrose per 100 mL, as recommended by the American Society for Parenteral and Enteral Nutrition 2

Critically ill patients should receive 200-300 grams of dextrose per day as part of their nutritional regimen, and the 78 grams provided represents only 26-39% of recommended carbohydrate intake, according to the Society of Critical Care Medicine 1
For a 70 kg patient, recommended carbohydrate intake is 3.0-3.5 g/kg/day, making this infusion only about 32-37% of recommended intake, as suggested by the American College of Nutrition 1

Using the guideline of 1 unit of insulin per 10-15 grams of carbohydrate, a patient with diabetes would require approximately 5-8 units of insulin per 24 hours for nutritional coverage, according to the American Diabetes Association 3, 1

This rate of D5 administration is typically used for medication vehicle/dilution rather than primary nutritional support, and for temporary glucose provision while awaiting enteral nutrition, as recommended by the American Society for Parenteral and Enteral Nutrition 2, 1
Blood glucose should be monitored every 1-2 hours when administering dextrose-containing fluids, and thiamine should be administered prior to starting glucose infusion to reduce risk of Wernicke's encephalopathy, according to the American College of Emergency Physicians 2, 5, 1