Intravenous infusion of a concentrated potassium chloride solution is toxic to endothelial cells and can negative affect a peripheral vein used for the infusion.

Potassium chloride is available in a concentrated solution that is usually added to a liter bag of intravenous infusate.


When a patient has severe hypokalemia and is at risk of fluid overload, it is tempting to use as concentrated a solution of potassium chloride as possible.


A concentrated solution of potassium chloride infused into a vein can result in:

(1) phlebitis

(2) thrombosis

(3) pain at the infusion site

(4) phlebosclerosis (if done repeatedly)

(5) extravasation injury if there is any perivenous leakage


Options for replacing potassium:

(1) infuse through a central line, which allows for a higher potassium than a peripheral vein

(2) infuse a dilute potassium solution in 2 or more peripheral veins

(3) if the patient is tolerant to oral intake, then supplement with oral potassium solutions

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