What are the precautions for intravenous potassium supplementation

Potassium is an indispensable trace element in the human body. If the human body lacks potassium, many complications will arise. Therefore, in daily life, everyone must not be picky about food, because there are many foods with relatively high potassium content. However, when supplementing potassium, colleagues also need to understand some related precautions, so that when there is any problem with the body, everyone will go to the hospital for treatment as soon as possible.

1. Potassium supplementation is required when urine volume exceeds 400 ml/d. The amount of potassium supplementation depends on the serum potassium concentration. For example, for fasting patients, 2-3g of potassium chloride is sufficient for physiological needs. For patients with severe potassium deficiency (serum potassium <2mmol/l), potassium chloride should be supplemented daily, but not more than 6-8g/d. If the patient is in shock and has oliguria, blood volume should be restored as soon as possible, and intravenous potassium supplementation should be performed only after the urine volume exceeds 30ml/h.

2. The potassium supplement concentration should not exceed 40mmol/l (potassium chloride 3g/l). It should be diluted and then dripped intravenously. Intravenous injection is prohibited to avoid a sudden increase in blood potassium concentration leading to cardiac arrest.

3. Potassium supplementation rate: When the patient has severe symptoms of potassium deficiency and serum potassium is <2.0mmol/l, intravenous infusion of potassium chloride should not be interrupted and the rate can be 1.5-2.0g/h. When the blood potassium rises to 3.0-3.5mmol/l, the rate can be reduced to 1.0-1.5g/h. When the blood potassium is >3.5mmol/l, potassium supplementation can be given intermittently and the rate is limited to <1.0g/h. Potassium supplementation according to the above method can continuously supply potassium ions to the serum to ensure normal conduction and contraction of the heart. The supplemented potassium ions have ample time to penetrate into the tissue fluid from the blood and then enter the cells, so as not to form hyperkalemia.

4. During intravenous potassium supplementation, attention must be paid to monitoring renal function, because 80% of the excess potassium in the body is excreted from the kidneys, so good renal function is a prerequisite for potassium supplementation. Except for the special case of polyuria renal failure, as long as the patient's daily urine volume exceeds 500ml, or has urinated within 6 hours, intravenous potassium supplementation can be given. During the potassium supplementation process, it is safe if the urine volume is >30ml/h.

After potassium supplementation, if the patient's consciousness gradually becomes clearer, breathing difficulties gradually ease, blood pressure returns to normal, bowel sounds disappear, and limbs gradually become stronger, it means that the treatment is effective[2]. If the patient experiences numbness and pain in the limbs, pale complexion, cold limbs, slow heartbeat, and premature beats, these are manifestations of hyperkalemia and potassium supplementation should be suspended.