Post Mortem Blood and Vitreous Humor Ethanol Levels Relation in Fars Legal Medicine Center

Document Type : Original Article

Authors

1 Specialist in Forensic Medicine,Legal Medicine Research Center, Legal Medicine Organization,Tehran, Iran.

2 Pharm D.Legal Medicine Research Center, Legal Medicine Organization,Tehran, Iran.

3 Immunology M.S Degree.Legal Medicine Research Center, Legal Medicine Organization,Tehran, Iran.

4 Chemistery M.S Degree.Legal Medicine Research Center, Legal Medicine Organization,Tehran, Iran.

5 Medical Laboratory Science B.S Degree.Legal Medicine Research Center, Legal Medicine Organization,Tehran, Iran.

6 Assistant Professor, Forensic Medicine Group.Forensic Medicine group, School of Medicine, Jundishpur University of Medical Sciences, Ahvaz, Iran.

7 General Practitioner, Legal Medicine Research Center, Legal Medicine Organization,Tehran, Iran.

Abstract

Background and Objective: The concentration of ethanol measured in postmortem blood needs to be interpreted as to whether the person who had consumed alcohol has exceeded some threshold limit. However, interpreting postmortem BAC (Blood Alcohol Concentration) results and drawing correct conclusions about ante mortem levels is fraught with difficulties as under some circumstances alcohol might be produced after death by microbial activity.
Subjects and Methods: In the case of ethanol, the blood samples should be taken from a femoral vein and whenever possible additional specimens, such as urine and vitreous humor (VH), should also be obtained and sent for analysis to be able to have the best interpretation
Results: 167 Specimens of femoral vein blood and vitreous humor were analyzed. In this study, direct injection and gas-chromatographic techniques were employed to quantitate the ethanol concentrations. These two concentrations were then compared and the BAC/VHAC (Viterous Humor Alcohol Concentration) ratio was evaluated.
Among these specimens, there were 142 cases in which we have found ethanol in blood but not in vitreous humor. Also we have found 2 cases by positive VHAC but negative BAC. The average blood ethanol concentration was 61.5 mg/dLit while the average ethanol vitreous humor concentration was 127 mg/dLit. However, the ratio was measured as 0.7.
Conclusion: The similarity in the results of the post mortem cases reinforces the assertion that co analysis of vitreous humor and blood is important to interpret post mortem results.

Keywords

References

1-Kugelberg FC, Jones AW. Interpreting results of ethanol analysis in postmortem specimens: a review of the literature. Forensic Sci Int 2007;165(1):10–29.
2-Clark JC. Sudden death in the chronic alcoholic. Forensic Sci Int 1988;36(1-2):105–11.
3-Hansen AU, Simonsen J. The manner and cause of death in a forensic series of chronic alcoholics. Forensic Sci Int 1991;49(2):171–8.
4-Crombie IK, Pounder DJ, Dick PH. Who takes alcohol prior to suicide? J Clin Forensic Med 1998;5(2):65–8.
5-Bilban M, Skibin L. Presence of alcohol in suicide victims. Forensic Sci Int 2005 Suppl;147: S9–12.
6-Jonsson A, Holmgren P, Ahlner J. Fatal intoxications in a Swedish forensic autopsy material during 1992–2002. Forensic Sci Int 2004;143(1):53–9.
7-Borges G, Cherpitel CJ, MacDonald S, Giesbrecht N, Stockwell T, Wilcox HC. A case-crossover study of acute alcohol use and suicide attempt. J Stud Alcohol 2004;65(6):708–14.
8-Girasek DC, Gielen AC, Smith GS. Alcohol’s contribution to fatal injuries: a report on public perceptions. Ann Emerg Med 2002;39(6):622–30.
9-Flanagan RJ, Connally G. Interpretation of analytical toxicology results in life and at postmortem.Toxicol Rev 2005;24(1):51–62.
10-Cook DS, Braithwaite RA, Hale KA. Estimating antemortem drug concentrations from postmortem blood samples: the influence of postmortem redistribution . J Clin Pathol 2000;53(4):282–5.
11-Yarema MC, Becker CE. Key concepts in postmortem drug redistribution.Clin Toxicol (Phila) 2005;43(4):235–41.
12-De Martinis BS, Martin CC. Automated headspace solid-phase microextraction and capillary gas chromatography analysis of ethanol in postmortem specimens. Forensic Sci Int 2002;128(3):115–19.
13-Hardin GG. Postmortem blood and vitreous humor ethanol concentrations in a victim of a fatal motor vehicle crash. J Forensic Sci 2002;47(2):402–3.
14-Gagajewski A, Murakami MM, Kloss J, Edstrom M, Hillyer M, Peterson GF, et al. Measurement of chemical analytes in vitreous humor: stability and precision studies. J Forensic Sci 2004;49(2):371–4.
15-Mulla A, Massey KL, Kalra J. Vitreous humor biochemical constituents: evaluation of between-eye differences. Am J Forensic Med Pathol 2005;26(2):146–9.
16-Madea B, Rodig A. Time of death dependent criteria in vitreous humor:accuracy of estimating the time since death. Forensic Sci Int 2006;164(2-3):87–92.
17-Pounder DJ, Kuroda N. Vitreous alcohol is of limited value in predicting blood alcohol. Forensic Sci Int 1994;65(2):73-80.
18-Maeda H, Zhu BL, Ishikawa T, Oritani S, Michiue T, Li DR, et al . Evaluation of post-mortem ethanol concentrations in pericardial fluid and bone marrow aspirate. Forensic Sci Int 2006;161:141–143
19-Winek CL , Esposito FM. Comparative study of ethanol levels in blood versus bone marrow, vitreous humor, bile and urine. Forensic Sci Int 1981;17(1):27–36.
20- Thierauf A, Musshoff F, Madea B. Post-mortem biochemical investigations of vitreous humor. Forensic Sci Int 2009;192(1-3):78–82.
21-Fazilati M, Iravani O, Ghadyani MH. Survey of comparative surface concentration liquid ethanol in vitreous eyes right and left in Legal Medicine Isfahan during 2006. Scientific Journal of Forensic Medicine 2008;13(4):241-248.  [In Persian]
22-Fernandez P, Lopez-Rivadulla M, Linares JM, Tato F, Bermejo AM. A comparative pharmacokinetic study of ethanol in the blood, vitreous humour and aqueous humour of rabbits. Forensic Sci Int 1989;41(1-2):61-5.
23-Barry L. Principle of  Forensic  Toxicology. 2nd ed. : American Association for Clinical Chemistry; USA; 2003. P. 10.
24-Harper DR. A comparative study of the microbiological contamination of postmortem blood and vitreous humour samples taken for ethanol determination. Forensic Sci Int 1989;43(1):37– 44.
25-Yajima D, Motani H, Kamei K, Sato Y, Hayakawa M, Iwase H. Ethanol production by Candida albicans in postmortem human blood samples: effects of blood glucose level and dilution. Forensic Sci Int 2006;164(2-3):116–21.
26-Pounder DJ, Kurodab N. Vitreous alcohol is of limited value in predicting blood alcohol. Forensic Sci Int 1994;65(2):73-80.
27-Chao TC, Lo DS. Relationship between postmortem blood and vitreous humor ethanol levels. Am J Forensic Med Pathol 1993;14(4):303-8.
Jundishapur Scientific Medical Journal
Volume 11, Issue 5
July and August 2017
Pages 565-576

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History

  • Receive Date: 15 August 2011
  • Revise Date: 19 May 2012
  • Accept Date: 12 June 2012

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