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
