Post-resuscitation · NRP
Dextrose Bolus for Neonatal Hypoglycemia
Initial IV dextrose bolus and continuous infusion for the newborn with documented, symptomatic or severe hypoglycemia. Bolus and infusion doses follow the AAP clinical report on postnatal glucose homeostasis; NRP 9th Edition (Lessons 8–9) recommends checking glucose and starting IV dextrose after resuscitation.
Birth weight
IV Bolus — D10W 2 mL/kg
- Dextrose
- —
- Fluid
- D10W (dextrose 10%)
Follow with continuous IV dextrose — GIR 5–8 mg/kg/min
| GIR (mg/kg/min) | D10W rate | D12.5W rate |
|---|
GIR (mg/kg/min) = (rate mL/h × dextrose %) ÷ (weight kg × 6). Target 5–8 mg/kg/min initially; up-titrate as needed. Concentrations > D12.5W require central venous access.
When to give the bolus (guide)
- Symptomatic hypoglycemia at any age (jitteriness, apnea, seizures, poor tone/feeding).
- Severe hypoglycemia not responsive to feeding.
- Follow institutional thresholds — commonly < 40 mg/dL (2.2 mmol/L) if symptomatic, or per AAP/PES protocol.
- Confirm with a lab plasma glucose whenever screening is by point-of-care.
Clinical decision support only. Follow the NRP 9th Edition post-resuscitation care guidance and your institutional hypoglycemia protocol. Verify concentrations, doses and access route with pharmacy and the neonatal team. PediaSuite is an independent study aid.
Reviewed by C. A. Leyva, MD, neonatologist · Last reviewed September 2026
References
- Adamkin DH; Committee on Fetus and Newborn. Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics. 2011;127(3):575–579. doi:10.1542/peds.2010-3851
- American Academy of Pediatrics, American Heart Association. Textbook of Neonatal Resuscitation. 9th ed. Itasca, IL: American Academy of Pediatrics; 2025. Lesson 8: Resuscitation and Stabilization of Preterm Infants; Lesson 9: Post-resuscitation Care.
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