When supplementing potassium for hypokalemia, what should be paid attention to?

Written by Wei Shi Liang

Intensive Care Unit

Updated on September 20, 2024

00:00

00:00

When supplementing potassium for hypokalemia, the following should be noted:

1. Closely monitor the blood potassium levels. Supplement 60-80 mmol/L of potassium, or recheck the blood potassium level within 1-4 hours after supplementation.

2. If the rate of potassium supplementation exceeds 10 moles per hour, continuous ECG monitoring should be maintained, closely observe the changes in the ECG, and prevent the occurrence of life-threatening hyperkalemia.

3. The rate of potassium supplementation for patients with regenerative dysfunction should be 50% of that for patients with normal kidney function.

4. The daily amount of potassium supplementation should not exceed 100-200 millimoles.

5. Try not to use peripheral veins for high-concentration potassium supplementation.

6. Use sodium chloride solution to dilute potassium-containing solutions, and it is not recommended to use glucose or low molecular weight dextrorotatory sugar as the carrier.

Other Voices

home-news-image

Written by Wang Li Bing

Intensive Care Medicine Department

41sec

home-news-image

How to replenish potassium for hypokalemia

After the occurrence of hypokalemia, we usually adopt oral potassium supplementation or intravenous potassium supplementation. Oral potassium supplementation is the safest method clinically, and patients can also be advised to consume potassium-rich fruits or vegetables, etc. On the other hand, there is intravenous potassium supplementation, which must be decided based on the patient's urine output. Generally, potassium supplementation can be carried out only when the patient's urine output is more than 500 milliliters per day. However, the concentration of potassium must be diluted and not administered undiluted to prevent arrhythmias and so on.

home-news-image

Written by Wei Shi Liang

Intensive Care Unit

51sec

home-news-image

How to radically cure hypokalemia?

Hypokalemia must be treated with potassium supplementation while simultaneously addressing the primary condition. For mild hypokalemia, oral potassium can be given in doses of 40 to 80 mmol/day. In cases of severe hypokalemia, where blood potassium is less than 2.0 mmol/L or when life-threatening symptoms are present, intravenous potassium should be administered at a rate of 10 to 20 mmol/L per hour. Regular monitoring of blood potassium levels is necessary, especially in cases of renal dysfunction and cellular uptake impairment. For life-threatening severe hypokalemia, potassium can be administered via central venous lines with close monitoring of blood potassium levels, and the infusion rate can reach up to 40 mmol/L, which can effectively cure hypokalemia.

home-news-image

Written by Gan Jun

Endocrinology

1min 15sec

home-news-image

How much potassium should be supplemented daily for hypokalemia?

For patients with hypokalemia, the amount of potassium ions needed each day depends on the severity of the hypokalemia. There are specific causes for the occurrence of hypokalemia; it does not occur without relevant medical history. It is commonly seen in cases of inadequate diet, diarrhea, insufficient intake of potassium ions, clinical use of diuretics, and acid-base imbalance. That is to say, hypokalemia can be caused only if these factors are present. Without these factors, hypokalemia will not occur. Patients with hypokalemia need potassium supplementation therapy. If it's not severe, oral potassium chloride can be administered. For a few severe cases of hypokalemia, patients may receive intravenous fluids. Generally, the principle is to supplement four to six grams of potassium chloride per day. Potassium supplementation should be strictly in accordance with medical advice, and it's important to monitor the concentration of blood potassium regularly to adjust the treatment plan appropriately. (Medication use should be under the guidance of a physician.)

home-news-image

Written by Wei Shi Liang

Intensive Care Unit

1min

home-news-image

Clinical symptoms of hypokalemia

Hypokalemia has diverse clinical manifestations. The most life-threatening symptoms involve the cardiac conduction system and the neuromuscular system. In mild hypokalemia, the electrocardiogram (ECG) shows flattened T waves or their disappearance, along with the appearance of U waves. Severe hypokalemia can lead to lethal arrhythmias, such as ventricular tachycardia, ventricular fibrillation, or sudden death. In the neuromuscular system, the most prominent symptoms of hypokalemia are in the skeletal muscle, presenting as sluggish paralysis and loss of tone in the smooth muscle, leading to rhabdomyolysis. If respiratory muscles are affected, it may result in respiratory failure. Hypokalemia can also cause insulin resistance and obstruct insulin release, leading to significant glucose tolerance abnormalities. Decreased potassium excretion reduces the kidney's ability to concentrate urine, resulting in polyuria.

home-news-image

Written by Wang Li Bing

Intensive Care Medicine Department

44sec

home-news-image

How to treat hypokalemia?

After the occurrence of hypokalemia, there are generally two methods of potassium supplementation clinically. The first is oral potassium supplementation, which is relatively safe, and one can also eat fruits or vegetables rich in potassium. The second method is intravenous potassium supplementation. The first thing to note with intravenous supplementation is the patient's urination status. If the patient’s urination is normal, potassium chloride can be administered intravenously but must be diluted. In clinical practice, the concentration of intravenous potassium chloride generally does not exceed 0.3%, so we must pay attention to the concentration during potassium supplementation.