Does the protocol require a back-step infusion of D5W?
A. No, we found that the use of dextrose–containing solutions actually exacerbated stress hyperglycemia in our nondiabetic population and as they started eating and the dextrose IV was turned off they became hypoglycemic if the insulin was not turned off. So we eliminated the use of dextrose-containing IV solutions in the immediate postoperative period, which markedly reduced the BG levels in nondiabetics and reduced the requirement for insulin in this population.
