title: Lactate concentration gradient from right atrium to pulmonary artery: a commentary.
abstract: Inadequate myocardial performance is a common complication of severe sepsis. Studies in humans strongly argue against a decrease in coronary blood flow in the pathogenesis of this sepsis-induced cardiac injury. Moreover, regional myocardial ischemia may well be present in sepsis patients with coexistent coronary artery disease. Nevertheless, the diagnosis of myocardial ischemia remains difficult in patients with sepsis, since elevation of troponin in these patients can be the result of a variety of conditions other than acute myocardial ischemia. The use of the right atrium to pulmonary artery lactate gradient could perhaps help the clinician in detecting myocardial ischemia in patients with sepsis.
authors.affiliation: Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Brussels, Belgium. jcreteur@ulb.ac.be
authors.forename: Jacques
authors.initials: J
authors.lastname: Creteur
mesh_terms: D015415:Biomarkers / Q000097:blood; D003326:Coronary Circulation; D006325:Heart Atria / Q000378:metabolism*; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D010100:Oxygen / Q000097:blood; D011651:Pulmonary Artery / Q000378:metabolism*; D018805:Sepsis / Q000150:complications
chemical_list: D015415:Biomarkers; D019344:Lactic Acid; D010100:Oxygen