Rate of IV infusion of potassium in severe hypokalemia should not exceed
Rate of K+ infusion should not exceed 20 mmol/hour unless paralysis or malignant ventricular arrhythmias are present. The use of intravenous administration should be limited to patients unable to use the enteral route or in the setting of severe complications (e.g., paralysis, arrhythmia). Intravenous K+-Cl- should always be administered in saline solutions, rather than dextrose, because the dextrose-induced increase in insulin can acutely exacerbate hypokalemia. The peripheral intravenous dose is usually 20-40 mmol of K+-Cl- per liter; higher concentrations can cause localized pain from chemical phlebitis, irritation, and sclerosis. If hypokalemia is severe (<2.5 mmol/L) and/or critically symptomatic, intravenous K+-Cl- can be administered through a central vein with cardiac monitoring in an intensive care setting, at rates of 10-20 mmol/h; higher rates should be reserved for acutely life-threatening complications. Ref: Harrison 19e pg: 308
20 mmol/hour
40 mmol/hour
60 mmol/hour
80 mmol/hour
Fluid and electrolytes