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With respect to Dr Fribourg's questions to us, we did mean to say that we would infuse as much as 80 to 100 mEq/L of potassium per hour to suppress the ventricular irritability in a patient with profound hypokalemia (less than 2 mEq/L). If this is done by two peripheral infusions containing 40 to 50 mEq of potassium per liter, we agree that this represents a large volume load. However, most patients with such profound hypokalemia also have substantial volume contraction from either vomiting or excessive diuretics. In addition, if the fluid is given as D5W, it will be distributed over totalbody water (ie, over 42 L in a 70-kg person), which will leave less than 10% of each liter in the intravascular space. We would like to state that such a clinical situation, ie, one where hypokalemia is so profound as to cause ventricular irritability,
Bia MJ, DeFronzo RA. Intravenous Potassium Chloride Therapy-Reply. JAMA. 1982;247(3):304–305. doi:10.1001/jama.1982.03320280026016
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