.gir-calculator-input-group { margin-bottom: 20px; }
.gir-calculator-input-group label { display: block; font-weight: 600; margin-bottom: 8px; color: #2c3e50; }
.gir-calculator-input-group input { width: 100%; padding: 12px; border: 1px solid #ccd1d9; border-radius: 6px; font-size: 16px; box-sizing: border-box; }
.gir-calculator-button { background-color: #0056b3; color: white; padding: 15px 25px; border: none; border-radius: 6px; font-size: 18px; font-weight: bold; cursor: pointer; width: 100%; transition: background-color 0.3s; }
.gir-calculator-button:hover { background-color: #004494; }
#gir-result-box { margin-top: 25px; padding: 20px; border-radius: 8px; background-color: #fff; border: 2px solid #0056b3; display: none; text-align: center; }
.gir-value { font-size: 32px; font-weight: 800; color: #0056b3; display: block; }
.gir-label { font-size: 16px; color: #555; }
.gir-status { margin-top: 10px; font-weight: bold; font-size: 14px; }
.neonatal-article { margin-top: 40px; border-top: 1px solid #eee; pt: 30px; }
.neonatal-article h2 { color: #2c3e50; margin-top: 25px; }
.neonatal-article h3 { color: #34495e; margin-top: 20px; }
.neonatal-article p { margin-bottom: 15px; }
.neonatal-table { width: 100%; border-collapse: collapse; margin: 20px 0; }
.neonatal-table th, .neonatal-table td { border: 1px solid #ddd; padding: 12px; text-align: left; }
.neonatal-table th { background-color: #f2f2f2; }
function calculateNeonatalGIR() {
var weight = parseFloat(document.getElementById('neonateWeight').value);
var rate = parseFloat(document.getElementById('fluidRate').value);
var dextrose = parseFloat(document.getElementById('dextroseConcentration').value);
var resultBox = document.getElementById('gir-result-box');
var output = document.getElementById('gir-output');
var statusMsg = document.getElementById('gir-status-message');
if (isNaN(weight) || isNaN(rate) || isNaN(dextrose) || weight <= 0) {
alert("Please enter valid positive numbers for all fields. Weight must be greater than zero.");
return;
}
// Formula: GIR (mg/kg/min) = (Rate (ml/hr) * Dextrose (%)) / (6 * Weight (kg))
// Explanation: (ml/hr * % * 10) / (60 * kg) simplifies to (rate * dextrose) / (6 * weight)
var gir = (rate * dextrose) / (6 * weight);
output.innerText = gir.toFixed(2);
resultBox.style.display = 'block';
if (gir 12) {
statusMsg.innerText = "Status: High GIR – Monitor for hyperglycemia";
statusMsg.style.color = "#c0392b";
} else {
statusMsg.innerText = "Status: Within common clinical range for most neonates";
statusMsg.style.color = "#27ae60";
}
}
Understanding Glucose Infusion Rate (GIR) in Neonates
The Glucose Infusion Rate (GIR) is a critical calculation used in neonatal intensive care units (NICUs) to determine the amount of glucose a newborn is receiving per minute, adjusted for their body weight. Maintaining stable blood glucose levels is essential for neonatal brain development and metabolic stability.
The GIR Calculation Formula
The standard mathematical formula used by clinicians is:
GIR (mg/kg/min) = [IV Rate (ml/hr) × Dextrose Concentration (%)] / [6 × Weight (kg)]
This formula simplifies the conversion from hours to minutes and percentage concentration to milligrams of glucose. Specifically, 1% dextrose equals 10 mg/ml, and there are 60 minutes in an hour, which results in the constant divisor of 6.
Why Monitoring GIR Matters
Neonates, especially those born preterm or small for gestational age (SGA), have limited glycogen stores and high metabolic demands. If the GIR is too low, the infant may suffer from hypoglycemia, which can lead to neurological issues. Conversely, an excessively high GIR can cause hyperglycemia, osmotic diuresis, and hepatic steatosis.
Standard GIR Reference Ranges
| Patient Condition |
Typical GIR Range (mg/kg/min) |
| Term Neonate (Starting) |
4 – 6 mg/kg/min |
| Preterm Neonate (Starting) |
6 – 8 mg/kg/min |
| Maximum Oxidation Rate |
12 – 15 mg/kg/min |
| Endogenous Production Rate |
4 – 6 mg/kg/min |
Example Calculation
If a neonate weighs 2.5 kg and is receiving 10% Dextrose (D10W) at a rate of 8 ml/hr:
- Weight: 2.5 kg
- Rate: 8 ml/hr
- Concentration: 10%
- Calculation: (8 × 10) / (6 × 2.5) = 80 / 15 = 5.33 mg/kg/min
In this scenario, the GIR of 5.33 falls within the normal physiological range for a stable neonate.
Clinical Considerations
When adjusting GIR, clinicians often move in increments of 0.5 to 2 mg/kg/min while closely monitoring serum glucose levels. It is important to remember that GIR calculations must include all sources of glucose, including TPN (Total Parenteral Nutrition) and arterial line fluids, to ensure an accurate clinical picture.