What concentration of IV fluids is recommended for treating hypoglycemia in a three-week-old infant?

When treating hypoglycemia in a three-week-old infant, the recommended concentration of intravenous (IV) fluids is D10, or 10% dextrose. This concentration is appropriate because infants, particularly newborns, have a lower capacity for gluconeogenesis due to their immature liver function. Therefore, they require a source of glucose that is safe and effective for correcting low blood sugar levels without leading to hyperglycemia.

Using D10 allows for a more gradual and controlled rise in blood glucose, which is essential in this vulnerable patient population. Higher concentrations, such as D25 or D50, could lead to excessively rapid increases in blood glucose and may put the infant at risk for complications such as hyperglycemia and osmotic diuresis, which is particularly undesirable in neonates.

Additionally, D5 (5% dextrose) is generally considered too weak for treating significant hypoglycemia in infants, as it may not provide enough glucose to effectively raise the blood sugar levels. Therefore, D10 is the safe and recommended choice for treating hypoglycemia in a three-week-old infant.