D10/D25/D50 Bolus
The Neonatal Hypoglycemia Dextrose Bolus Calculator provides weight-based dosing for treating hypoglycaemia, covering IV dextrose boluses at three concentrations, a maintenance glucose infusion rate, an intramuscular/subcutaneous rescue option for when there is no IV access, and second-line adjuncts for persistent hypoglycaemia. All bolus options are calculated to deliver the same 0.5 g/kg dextrose dose regardless of concentration used. The tool also flags the critical laboratory sample that should be drawn while the patient is still hypoglycaemic.
The app calculates 5 mL/kg of 10% dextrose (equal to 0.5 g/kg), noted as safe through a peripheral IV line; equivalent 25% (2 mL/kg) and 50% (1 mL/kg) options are also given for central-line use.
The app targets a glucose infusion rate of 6–8 mg/kg/min of 10% dextrose, and points to the app's separate Glucose Infusion Rate (GIR) Calculator for two-stock mixing.
The app calculates glucagon 0.003 mg/kg plus adrenaline (epinephrine) 0.01 mg/kg, given intramuscularly or subcutaneously as a bridge until IV access is obtained.
The app specifies a 'critical sample' while the patient is still hypoglycaemic: insulin, C-peptide, cortisol, growth hormone, free fatty acids, lactate, beta-hydroxybutyrate, ammonia, LFTs, urine glucose and ketones, plasma amino acids, acylcarnitine profile, and IGF-1.
The app calculates these as adjuncts when the glucose requirement exceeds 10 mg/kg/min, suggesting hyperinsulinism — diazoxide 3–8 mg/kg/day divided every 12 hours, or octreotide 10 mcg/kg IV or subcutaneously every 8 hours.