When selecting the type of infusion solution and the volume/rate of infusion for a geriatric patient, consider that geriatric patients are generally more likely to have cardiac, renal, hepatic impairment, and other diseases or concomitant drug therapy. Glucose solution (an aqueous, i.e., electrolyte-free glucose solution) should not be administered through the same equipment as whole blood, as haemolysis and pseudoagglutination can occur.

If < 2.0 mmol/l after initial feed or if still hypoglycaemic on 1hly feeds, treat with IV Glucose as below Screen capillary blood samples for hypoglycaemia immediately prior to each feed (3 hourly) using a cot-side testing device. Aim to maintain a pre-feed blood glucose of ≥2.5 mmol/l. If blood glucose values <2.5 mmol/l are obtained follow the management pathways. thiamine deficiency, e.g., in patients with chronic alcoholism (risk of severe lactic acidosis due to impaired oxidative metabolisation of pyruvate), Immunosuppression and other factors such as hyperglycaemia, malnutrition and/or their underlying disease state may predispose patients to infectious complications.

Objectives

If signs of pulmonary distress occur, the infusion should be stopped and medical evaluation initiated. water and electrolyte disturbances that could be aggravated by increased glucose and/or free water load (see above). A gradual increase of flow rate should be considered when starting administration of glucose-containing products. Solutions containing glucose should be used with caution, if at all, in patients with known allergy to corn or corn products. The infusion rate and volume depends on the age, weight, clinical and metabolic conditions of the patient, as well as concomitant therapy.

As with the intravenous administration of nutrients (e.g., glucose, amino acids and lipids) in general, metabolic complications may occur if the nutrient intake is not adapted to the patient's requirements, or the metabolic capacity of any given dietary component is not accurately assessed. Adverse metabolic effects may arise from administration of inadequate or excessive nutrients or from inappropriate composition of an admixture for a particular patient's needs. Dilution or addition to parenteral nutrition admixtures must take place in controlled and validated aseptic conditions. Once blood glucose level if 4mmol/l or above given 10-15g of slow acting carbohydrate (or their normal meal if it is a mealtime) to maintain the blood glucose level Additives known or determined to be incompatible with glucose as a diluent should not be used. The instructions for use of the medication to be added, including information on storage, must be consulted. Infection and sepsis may occur as a result of the use of intravenous catheters to administer parenteral formulations, poor maintenance of catheters or contaminated solutions.

Brand

Children (including neonates and older children) are at increased risk of developing hypoosmotic hyponatraemia as well as for developing hyponatraemic encephalopathy. Discontinue monitoring when blood glucose concentrations have been > 2.5mmol/l on three consecutive occasions at least 3 hours apart. Observe feeding in hospital for at least a further 24 hours ensuring it is effective while remaining vigilant for the signs of hypoglycaemia. If signs of hypoglycaemia develop or there are concerns about feeding discuss with medical staff and consider taking a further blood glucose. avoid infusion within the first 24 hours following head trauma. Monitor blood glucose closely as early hyperglycaemia has been associated with poor outcomes in patients with severe traumatic brain injury.