Extreme central acidosis from Abbott epinephrine.

Investigation into the cause of extreme systemic acidosis during cardiac arrest led to the discovery that a major contributing factor was Abbott 1:10,000 single-dose epinephrine, which contained a large unsuspected acid level. Analysis of this product, both in vivo and in vitro, demonstrated that it contained 8.2 times the acid content of a presumably identical product from Bristol Laboratories and also of a presumably identical product from Bristol Laboratories and also 1,850 times the acid content of an identical epinephrine dose made from a Parke-Davis preparation. Abbott epinephrine injected into the central circulation or directly into the heart causes extreme acidemia, which may be potentially lethal by itself when superimposed on pre-existing acidosis as in cardiac arrest.