Glucose Infusion Rate

(Version 1.0 7/1/1998 - 6/12/2007)

Glucose Infusion Rate can be calculated using either of the following formulas:

    GIR (mg/kg/min) = Volume (mL/kg/d) x Glucose concentration (as a decimal) ÷ 1.44

    Or

    GIR (mg/kg/min) = IV rate (mL/hr) x Dextrose concentration (g/dL) x 0.167

                                                            Weight (kg)

     *Note*  -    A Glucose Delivery Calculator can be found at NICU Tools.

Most infants will be euglycemic on an initial GIR of 5 – 8 mg/kg/min.

The maximal GIR needed to optimize nutrition is 14 mg/kg/min.

Infants who are hyperinsulinemic or have minimal glycogen stores may need a higher glucose infusion rate than 5 – 8 mg/kg/min to maintain euglycemia. The requirement for a GIR > 20 mg/kg/min is essentially diagnostic of hyperinsulinemia.

ELBW infants frequently become hyperglycemic despite minimal glucose intakes. These infants should not be maintained on a GIR < 5 mg/kg/min for any lengthy period of time; instead, they should probably receive exogenous insulin infusion to increase their cellular glucose uptake.

Remember that rapidly increasing the fluid volumes administered to <1000g infants in the first days of life will simultaneously increase the GIR unless adjustments are made. Similarly when an infant is dramatically fluid restricted due to a PDA or renal failure, the dextrose concentration in the iv fluids should be adjusted to maintain a consistently adequate GIR.

References:

Taeusch HW, Ballard RA, eds. "Disorders of carbohydrate metabolism." Avery’s Diseases of the Newborn, 7th edition, 1998.

Thureen PJ, Hay WW Jr. Intravenous nutrition and postnatal growth of the micropremie. Clin Perinatol 2000; 27 (1):197-221.

 

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