Q: What's the etiology behind lactic acidosis from intravenous epinephrine infusion?
Answer: Out of all the intravenous vasopressors used in ICU, epinephrine is known to be the most notorious to cause lactic acidosis.
Two mechanisms have been proposed. Postulation is that they may be happening together. One is the increased glycolytic activity in skeletal muscles and second is the hypoperfusion of gut causing lactic acidosis.
Day NP, Phu NH, Bethell DP, et al. The effects of dopamine and adrenaline infusions on acid-base balance and systemic haemodynamics in severe infection. Lancet 1996; 348:219.