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Parenteral Nutrition Glucose Rate — FRCA Final MCQ

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HardIntensive Care MedicineParenteral Nutrition Glucose RateFRCA Final

A 55-year-old man (ASA III) on ICU requires parenteral nutrition via a central line. What is the maximum recommended glucose infusion rate to avoid hyperglycaemia and hepatic steatosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — 10 mg/kg/min

The maximum recommended glucose (dextrose) infusion rate for parenteral nutrition in critically ill adults is approximately 4-5 mg/kg/min (some guidelines cite up to 5 mg/kg/min). Exceeding this rate overwhelms the body's capacity to oxidise glucose, leading to hyperglycaemia, hepatic steatosis, increased CO2 production (increased respiratory quotient >1.0, potentially making ventilator weaning difficult), and increased lipogenesis. Insulin may be required concurrently. The total caloric target in critical illness is typically 25-30 kcal/kg/day, with protein 1.2-2.0 g/kg/day.

Reference: ESPEN – 2019 – ICU nutrition guidelines; ICS – 2023 – Nutrition in critical care