Select the TRUE statement concerning administration of glucose-containing solutions to the patient with a closed head injury versus a patient with a spinal cord injury.

Select the TRUE statement concerning administration of glucose-containing solutions to the patient with a closed head injury versus a patient with a spinal cord injury.

• A. Glucose-containing solutions are contraindicated in both patient groups
• B. Glucose-containing solutions are contraindicated in patients with closed head injury but acceptable in patients with spinal cord injuries
• C. Glucose-containing solutions are acceptable in patients with closed head injuries but contraindicated in patients with spinal cord injuries
• D. Glucose-containing solutions may be given to either patient group if blood glucose concentrations do not exceed 200 mg/dL

Answer: (A)

The main point is why giving glucose-containing IV fluids after CNS injuries is avoided. In closed head injury and in spinal cord injury, high glucose levels can worsen brain or spinal cord injury by promoting edema and secondary injury. Hyperglycemia is linked to poorer outcomes because it increases osmolar load and can drive inflammatory and ischemic processes in damaged neural tissue. Because of this, glucose-containing solutions are generally avoided in the acute management of both conditions, and fluids without glucose (like isotonic saline) are preferred unless there is a separate, compelling need to treat true hypoglycemia. The idea that you’d gate the use of glucose on a specific blood sugar threshold (like 200 mg/dL) isn’t consistent with the approach of maintaining euglycemia in CNS injury, so the statement that glucose-containing solutions are contraindicated in both patient groups best fits the clinical reasoning.

The main point is why giving glucose-containing IV fluids after CNS injuries is avoided. In closed head injury and in spinal cord injury, high glucose levels can worsen brain or spinal cord injury by promoting edema and secondary injury. Hyperglycemia is linked to poorer outcomes because it increases osmolar load and can drive inflammatory and ischemic processes in damaged neural tissue. Because of this, glucose-containing solutions are generally avoided in the acute management of both conditions, and fluids without glucose (like isotonic saline) are preferred unless there is a separate, compelling need to treat true hypoglycemia. The idea that you’d gate the use of glucose on a specific blood sugar threshold (like 200 mg/dL) isn’t consistent with the approach of maintaining euglycemia in CNS injury, so the statement that glucose-containing solutions are contraindicated in both patient groups best fits the clinical reasoning.