Trouble with understanding pH-related death

[mlbdestined]

I'm having trouble understanding what effects acidemia and alkalemia have on the body that LEADS TO death.

I have scoured the internet to no avail. I was told by my preceptor that both acidemia and alkalemia affects the conduction of the electrical stimulation of the body and they can impact the cellular extraction of oxygen off heme molecules.

Is this true?

So is it that the worse the pH gets one way or the other than the pt is more prone to arrhythmias and hypoxia?

Is there a difference in effects leading to death from alkalemia versus acidemia, or are the effects the same that cause death of these things?

Thanks sooooo much for all your help fellow nurses, as I am confused:

[rkealy, BSN]

Also you will hear that pressors don't work once the pH gets really low.

.

That is true. Thats why after complete fluid resucitation fails, and levophed begin to become ineffective switch to Vasopressin ASAP. Vasopressin is a hormone that works much differently. Ideally you would begin CRRT Immediatly when noticing metabolic acidosis in septic shock

[Chisca, RN]

At least from an electrolyte viewpoint the body can tolerate acidosis far better than alkalosis. Acidosis drives the potassium out of the cells leading to hyperkalemia and alkalosis drives the potassium back in leading to hypokalemia. One of the big dialysis companies is involved in a lawsuit over the fact they changed the bicarb levels in dialysis baths without informing the physicians. Dialysis patients who were bordeline low potassium have died from cardiac arrest while on dialysis due to the alkalosis induced by the alkaline bath. Easy to adjust if you know but neither the doctors or nurses were informed.