GlucoBoost - Glucose Gel - Pack of 3

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When Glucose 40% w/v is used in conjunction with amino acids, the rate of administration of glucose should not exceed 1g/kg/hour for optimal protein anabolism. water and electrolyte disturbances that could be aggravated by increased glucose and/or free water load (see above). As indicated on an individual basis, vitamins and trace elements and other components (including amino acids and lipids) can be added to the parenteral regimen to meet nutrient needs and prevent deficiencies and complications from developing.

Notify Paediatrician immediately for all babies who are symptomatic or whose blood Glucose is <1.0mmol/l Babies who cannot tolerate enteral feeds or whose blood glucose remains <2.6mmol/l despite frequent NG feeds ( as above) OR who become symptomatic Enteral feeds may continue initially but if hypoglycaemia persists despite increasing volumes of IV Glucose then a temporary cessation of enteral feeds may be required.When using an infusion pump all clamps on the intravenous administration set must be closed before removing the administration set from the pump, or switching the pump off. This is required regardless of whether the administration set has an anti-free flow device. If < 2.0 mmol/l after initial feed or if still hypoglycaemic on 1hly feeds, treat with IV Glucose as below Near patient testing devices tend to be less accurate in the lower range, especially < 2.0mmol/l [1] and therefore all low values (≤2.6mmol/L) require confirmation using blood gas analysis as this is considered the gold standard for measuring blood glucose. 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. Hypersensitivity/infusion reactions, including anaphylactic/anaphylactoid reactions, have been reported (see section 4.8).

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.

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Rapid administration of glucose solutions may produce substantial hyperglycaemia and a hyperosmolar syndrome. 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. To reduce the risk of hypoglycaemia after discontinuation, a gradual decrease in flow rate before stopping the infusion should be considered.

If signs of pulmonary distress occur, the infusion should be stopped and medical evaluation initiated. Dilution or addition to parenteral nutrition admixtures must take place in controlled and validated aseptic conditions.

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Do not use plastic containers in series connections. Such use could result in air embolism due to residual air being drawn from the primary container before the administration of the fluid from the secondary container is completed. Snap the lid off the tube of gel and squeeze gel into the child’s lower cheek whilst at the same time gently but firmly massaging the outside of the cheek. It is this action that stimulates partial absorption of the Glucogel. DO NOT place gel on your own finger to rub inside your child’s mouth. Careful symptomatic and laboratory monitoring for fever/chills, leukocytosis, technical complications with the access device, and hyperglycaemia can help recognize early infections.

Use of a vented intravenous administration set with the vent in the open position could result in air embolism. Vented intravenous administration sets with the vent in the open position should not be used with flexible plastic containers. If > 2.6 mmol/l resume frequent, 3 hly, feeding of at least 10ml/kg/feed and monitor Glc before each feed To reduce the risk of hyperglycaemia-associated complications, the infusion rate must be adjusted and/or insulin administered. Glucose 40% w/v is for administration by intravenous infusion following appropriate dilution or incorporation in to a parenteral nutrition admixture. The dosage and rate of administration of Glucose 40% w/v are determined by several factors including the indication for use and the patient's age, weight and clinical condition.Use of an in-line filter is recommended during administration of all parenteral solutions where possible. Rapid correction of hypoosmotic hyponatraemia is potentially dangerous (risk of serious neurologic complications). Dosage, rate, and duration of administration should be determined by a physician experienced in paediatric intravenous fluid therapy. Particular caution is advised in patients at increased risk of water and electrolyte disturbances that could be aggravated by increased free water load, hyperglycaemia or possibly required insulin administration (see below). If the baby has an ongoing requirement of ≥120 ml/kg/day of milk / 10% glucose to maintain normoglycaemia, refer to the guideline for refractory hypoglycaemia