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: 12/14/2019)
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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