Ethanol levels in postmortem body fluids

Insights into the Origin of Postmortem Ethanol

“…By performing multispecimen analysis, the atypical distribution of EtOH throughout the different compartments of the corpse could indicate postmortem EtOH generation (Corry 1978; O’Neal and Poklis 1996). The fluid/blood or tissue/blood ratios described in the literature could be used either to estimate the BAC at the time of death, or as potential indicators of postmortem EtOH production (Budd 1982).…”

“…Urine has been an alternative specimen widely used for postmortem EtOH determination. Many studies have reported an average urine/blood ratio ranging from 1.01 to 1.5, whereas absolute ratio values reported have shown a greater variation, ranging from 0.21 to 3.67 (Jetter 1938; Bavis 1940; Ellenbrook and Van Gaasbeek 1943; Coldwell and Smith 1959; Heise 1967; Kaye and Cardona 1969; Christopoulos, Kirch, and Gearrien 1973; Backer, Pisano, and Sopher 1980; Budd 1982; Stone and Rooney 1984; Levine and Smialek 2000; Jones and Holmgren 2003). The observed discrepancies suggest that urine alcohol concentration would result in uncertainty in estimating the BAC.…”

“…Cerebrospinal fluid (CSF), on the other hand, could be a close indicator of the EtOH concentration in the central nervous system (CNS). Average CSF/blood EtOH concentration ratios have been reported to range from 0.9 to 1.18 depending on the time after drinking and the phase of elimination (Gettler and Freireich 1931; Harger, Hulpieu and Lamb 1937; Christopoulos, Kirch, and Gearrien 1973; Backer, Pisano, and Sopher 1980; Budd 1982).…”

“…Moreover, it has been easy to be obtained during autopsy and has been relatively stable postmortem. Relative studies have shown that the average VH/blood ratio ranged from 0.91 to 1.34 (Felby, Pharm, and Olsen 1969; Coe and Sherman 1970; Scott, Root, and Sanborn 1974; Backer, Pisano, and Sopher 1980; Budd 1982; Stone and Rooney 1984; Sylvester et al 1998).…”

“…Brain has also shown great variability in postmortem EtOH concentration depending on the part of the brain measured. Absolute brain/blood EtOH concentration ratios ranged from 0.31 to 8.00, which has not been surprising in view of the heterologous make-up of the brain (Gettler and Freireich 1931;Ellenbrook and Van Gaasbeek 1943;Hine 1951;Herold and Prokop 1960;Christopoulos, Kirch, and Gearrien 1973;Backer, Pisano, and Sopher 1980;Budd 1982). Cerebrospinal fluid (CSF), on the other hand, could be a close indicator of the EtOH concentration in the central nervous system (CNS).…”