Concentrated dextrose (50% dextrose, D50W) may be infused in a patient with severe hypoglycemia. Extravasation of the dextrose can result in serious tissue damage and rarely death.
Patient selection: extravasation of concentrated dextrose from an intravenous infusion for hypoglycemia
Mechanism of injury: hyperosmolarity
Complications of the extravasation:
(1) swelling
(2) erythema
(3) acute pain
(4) skin and soft tissue necrosis
Uncommon or rare complications:
(5) venous thrombosis
(6) arterial thrombosis with gangrene and amputation
(7) chronic neuropathy, including complex regional pain syndrome (CRPS)
(8) cellulitis
(9) death
An extravasation of concentrated dextrose needs to be managed aggressively. Wiegand and Brown recommended injecting a solution of hyaluronidase (150 units per mL in 1 mL doses) around the extravasation site (not an FDA approved indication).
To read more or access our algorithms and calculators, please log in or register.
