Since the tolerance of glucose (dextrose) may be impaired in patients with diabetes mellitus, renal insufficiency or in an acute critical condition, their clinical and biological parameters, in particular the concentration of electrolytes in blood plasma, including magnesium and phosphorus, concentration glucose in the blood.
In the presence of hyperglycemia, the rate of administration drug or prescribe short-acting insulin.
In episodes of intracranial hypertension, a careful control of the concentration of glucose in the blood is necessary.
The use of dextrose solutions can lead to hyperglycemia.Therefore, they are not recommended for administration after acute ischemic stroke, since hyperglycemia is associated with increased ischemic damage to the brain and prevents recovery.
Particularly careful clinical monitoring is required at the beginning of intravenous administration of the drug. Carbohydrate solutions without a sufficient electrolyte content can not be used for rehydration therapy, as this can lead to a significant reduction in the serum levels of electrolyte concentrations, in particular to severe hyponatremia and hypocalcemia, with potentially harmful consequences for the patient, such as brain damage or heart disease. In particular, children, elderly and weakened patients are at risk. In the case of deficiency of electrolytes, such as hyponatremia or hypokalemia, the solution should not be used without proper substitution of electrolytes.
It is necessary to control the concentration of glucose and electrolytes in the blood, the water balance, and also the acid-base balance of the organism.
The appointment of hyperosmolar glucose solutions may lead to an increase in intracranial / intraspinal pressure in patients with a compromised integrity of the blood-brain barrier.
Various conditions accompanied by metabolic disorders (eg, after surgery or after trauma, with hypoxia or organ insufficiency), can slow down the oxidative metabolism of glucose and lead to metabolic acidosis.
Hyperglycemia should be properly monitored and if necessary, controlled by the introduction of short-acting insulin. The introduction of insulin leads to an additional movement of potassium into the cells and, consequently, can cause hypokalemia or aggravate coy.
In newborns, especially preterm or low birth weight, the risk of hypo- or hyperglycemia is increased, so during intravenous administration of solutions Dextrose requires careful monitoring of glucose concentration in blood in avoid long-term undesirable consequences. Hypoglycaemia in newborns can lead to long spasms, coma and brain damage.
Hyperglycemia is associated with intraventricular hemorrhage, delayed bacterial and fungal infectious diseases, retinopathy of prematurity, necrotic enterocolitis, bronchopulmonary dysplasia, prolonged hospitalization and death.
To avoid potentially fatal overdose with intravenous medications in newborns, special attention should be given to the method of administration. Devices for intravenous infusion and other equipment for the administration of drugs should be monitored regularly.