Authors: Ankur Verma, Sanjay Jaiswal, Clifford Reid, Priyadarshini Borah, Maheshwar Lal, Saumya Gupta, Palak Khanna
Published in: American Journal of Emergency Medicine, June 4, 2024
Conclusion: The study concluded that lower concentrations of dextrose (10% and 25%) are as effective as 50% dextrose in restoring mental status to a GCS of 15 in hypoglycemic patients in the ED. This suggests that lower concentrations can be safely used, potentially reducing the risks associated with higher dextrose concentrations. Further research might focus on the long-term outcomes and patient satisfaction associated with these different treatments.
Methods:
- Design: Randomized controlled single-blinded study
- Setting: Emergency Department
- Participants: Hypoglycemic patients presenting with altered mental status
- Intervention: Patients were randomly assigned to receive 5g boluses of 10%, 25%, or 50% dextrose, administered intravenously over 1 minute.
- Primary Outcomes: Time to achieve a Glasgow Coma Scale (GCS) of 15 and median total dextrose dose administered.
Results:
- Participants: 204 patients were included in the analysis.
- Time to Recovery: Median time to reach a GCS of 15 was 6 minutes across all treatment groups, showing no significant difference.
- Dextrose Dosage: The total median dose was lower in the 10% and 25% dextrose groups compared to the 50% group (10g vs. 15g).
- Maximum Dose Usage: A higher proportion of patients in the 50% group required the maximum dose of 25g compared to the 10% and 25% groups (12% vs. 3% and 4%, respectively).