UMEM Educational Pearls

Category: Critical Care

Title: Vasopressors and acidosis

Keywords: vasopressors, acidosis, bicarbonate (PubMed Search)

Posted: 10/23/2007 by Mike Winters, MD (Updated: 7/11/2020)
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Binding of vasopressor agents to their receptors is influenced by pH (and temperature and concentration)
Acidic conditions have been shown to alter receptor numbers on cell surfaces as well as alter binding affinity
Overall, pH values > 7.15 do not have an appreciable clinical effects on vasopressors
At pH values < 7.1 reductions in effectiveness become apparent
Routine administration of bicarbonate remains controversial
Aggressively search for and treat the underlying cause of the acidosis