From the FDA Drug Label
The dose and rate of administration are dependent upon the specific condition of each patient. Highest concentrations (300 and 400 mEq/L) should be exclusively administered via central route Recommended administration rates should not usually exceed 10 mEq/hour or 200 mEq for a 24-hour period if the serum potassium level is greater than 2. 5 mEq/liter
The maximum allowed concentration of KCl in a central line is 400 mEq/L 1.
- The administration rate should not exceed 10 mEq/hour or 200 mEq for a 24-hour period if the serum potassium level is greater than 2.5 mEq/liter.
- In urgent cases, rates up to 40 mEq/hour or 400 mEq over a 24-hour period can be administered with careful monitoring 1.
From the Research
The maximum allowed concentration of potassium chloride (KCl) for administration through a central line is up to 200 mEq/L, as supported by the most recent and highest quality study 2. When administering KCl through a central line, it's essential to use an infusion pump for precise control of the rate, monitor the patient's serum potassium levels regularly, and observe for signs of hyperkalemia such as cardiac arrhythmias, muscle weakness, or paresthesias. Some key points to consider when administering KCl through a central line include:
- Using an infusion pump for precise control of the rate
- Monitoring the patient's serum potassium levels regularly
- Observing for signs of hyperkalemia
- Being aware of the maximum infusion rate, which should generally not exceed 20 mEq/hour for central administration, though rates up to 40 mEq/hour may be used in severe hypokalemia under close cardiac monitoring, as noted in 3 and 2. It's also important to note that the higher concentration of KCl is possible in central lines because the medication is rapidly diluted by the high blood flow in the large central veins, reducing the risk of vein irritation and phlebitis that would occur in smaller peripheral veins, as discussed in 3. Overall, the administration of KCl through a central line requires careful consideration of the concentration and infusion rate to ensure safe and effective treatment of hypokalemia, as emphasized in 4.