- 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