Glucose Infusion Rate (GIR)
The GIR quantifies the rate at which glucose is delivered per kilogram per minute. It is the essential metric for managing neonatal glucose homeostasis — from the first IV dextrose bolus through complex TPN programming for hyperinsulinism.
Formula
GIR (mg/kg/min) = [D% × rate (mL/hr) × 1000] ÷ [weight (kg) × 60 × 100]
Equivalently: GIR = [dextrose% × mL/hr] ÷ [weight × 0.6]
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Dextrose-containing fluids
Find rate for a target GIR
Typical GIR targets
| Clinical scenario | GIR (mg/kg/min) |
|---|---|
| Term infant, maintenance | 4–6 |
| Preterm infant, maintenance | 5–8 |
| Hypoglycemia treatment | 6–8 |
| Persistent/refractory hypoglycemia (HI) | 8–12+ |
| Hyperinsulinism, diazoxide-unresponsive | 12–15+ |
GIR per line: [dextrose% × rate(mL/hr) × 1000] ÷ [weight(kg) × 60 × 100]; total is the sum across dextrose-containing fluids. Standard reference: ASPEN Core Curriculum, clinical nutrition in neonates.
Frequently asked questions
What is a normal GIR?
Maintenance is about 4–6 mg/kg/min in term and 5–8 in preterm infants; persistent hypoglycemia may require 8–12 or more.
Can I enter a fluid volume instead of a rate?
Yes — switch the unit to mL/kg/day; with a weight entered it converts to mL/hr automatically.
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