Dextrose Danger: Stroke Recovery And Sugar's Negative Impact

Dextrose, or glucose, is avoided in stroke patients due to the risk of increasing the severity of cerebral edema. Dextrose is a hypo-osmolar fluid, and administering it to stroke patients carries a theoretical risk of creating an osmotic gradient that would shift free water across the blood-brain barrier, increasing intracranial pressure and the severity of brain edema. Brain edema is a common cause of in-hospital death from acute ischemic stroke.

Dextrose solutions may increase the risk of cerebral edema in stroke patients

Cerebral edema is a common cause of in-hospital death from acute ischemic stroke. It is often a result of occlusion of the major intracranial arteries or multi-lobar stroke. Brain edema is thought to peak somewhere between 3 and 5 days after the initial ischemic event.

While this is a theoretical risk, there is usually not a compelling reason to take the chance of giving a hypo-osmolar IV solution to patients with acute ischemic stroke. Therefore, it is common practice to avoid such solutions in these patients.

Dextrose solutions may increase the risk of intracranial hypertension in stroke patients

While this is a theoretical risk, there is usually not a compelling reason to risk giving a hypo-osmolar IV solution to patients with acute ischemic stroke, and common practice is to avoid such solutions in these patients.

Dextrose solutions may increase the risk of death in stroke patients

Cerebral edema is the swelling of the brain due to an excess accumulation of water. This can be caused by a reduction in blood flow to the brain, known as ischemia, which can be further exacerbated by hyperglycemia, or high blood glucose levels.

In patients with acute ischemic stroke, the administration of a hypo-osmolar fluid such as 5% dextrose carries a theoretical risk of increasing the severity of cerebral edema. This is due to the creation of an osmotic gradient that would shift free water across the blood-brain barrier, leading to an increase in intracranial pressure and potentially fatal brain damage.

While this risk is theoretical, there is usually not a compelling reason to administer a hypo-osmolar IV solution to patients with acute ischemic stroke, and common practice is to avoid such solutions in these patients.

Dextrose solutions may increase the risk of pulmonary oedema in stroke patients

Dextrose solutions are avoided in patients with acute ischemic stroke as they carry a theoretical risk of increasing the severity of cerebral edema. This is due to the creation of an osmotic gradient that shifts free water across the blood-brain barrier to balance out the hypo-osmolar effects of these solutions in the plasma.

In a study comparing colloids with crystalloids, the odds of pulmonary oedema were approximately doubled with colloids compared with crystalloids. The crystalloid comparators were Ringer's lactate and 0.9% saline.

Dextrose solutions are also avoided due to the risk of worsening cerebral oedema.

Dextrose solutions may increase the risk of pneumonia in stroke patients

• Dextrose solutions are hypotonic and have a theoretical risk of increasing the severity of cerebral edema, which is a common cause of in-hospital death from acute ischemic stroke.
• Dextrose solutions can create an osmotic gradient that shifts free water across the blood-brain barrier, leading to a higher risk of pulmonary edema and pneumonia.
• Dextrose solutions can increase the risk of hyponatremia and hyperglycemia in people with diabetes.
• Dextrose solutions can cause infection around intravenous or subcutaneous cannulas, leading to cellulitis or systemic infection.
• Dextrose solutions may cause harm by increasing fluid volume, which can lead to cerebral or pulmonary edema, cardiac failure, or hyponatremia.

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