Helium suicide – A suffocation or a barotrauma?

Smędra, Anna; Łabętowicz, Piotr; Wochna, Katarzyna; Berent, Jarosław

doi:10.1016/j.jflm.2020.102065

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…In addition, a careful histological examination is required for distinguishing these from positive pressure ventilation; pre-existing disease such as chronic pulmonary emphysema; and death due to cardiac oedema, acute asthma or intoxications [ 48 , 49 ]. In particular, and although in all our cases toxicological analyses were negative, one should remember that inhalational drug abuse (cocaine) and inhalation of certain gases can also cause PBt [ 50 , 51 ] and, thus, results in a misinterpretation of histopathological findings.…”

Section: Discussionmentioning

confidence: 74%

Pulmonary barotrauma in SCUBA diving-related fatalities: a histological and histomorphometric analysis

Casadesús

Nieto‐Moragas

Serrando

et al. 2023

Forensic Sci Med Pathol

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Arterial gas embolism following pulmonary barotrauma occurs in 13–24% of cases of diving deaths. The study aimed to evaluate the usefulness of a histomorphometric digital analysis in the detection of air space over-distension due to pulmonary barotrauma. The study was performed on lung parenchyma specimens of 12 divers: six had died due to arterial gas embolism following pulmonary barotrauma (mean age at death of 54 years, range of 41–61 years), and six had drowned in saltwater without a diagnosis of pulmonary barotrauma (mean age at death of 54 years, range of 41–66 years) (positive controls). For negative controls, six cases of non-SCUBA divers (mean age of death of 42 years, range of 23–55 years) who died of intracerebral haemorrhage were evaluated. No significant differences were observed in the characteristics of the air spaces between control groups (positive and negative). However, differences were observed in the area occupied by air spaces and the percentage of air space area when we compared the case group to the controls (p < 0.01); and there was a slight difference in the maximum and minimum diameters of air space (p < 0.05). The mean area occupied by air spaces and the mean percentage of air space were the most useful for discriminating pulmonary barotrauma from other causes of death (100% sensitivity and 91.7% specificity). Based on our study, inclusion of an increased pattern of air spaces as a possible diagnostic criterion for pulmonary barotrauma would be useful in discerning the cause of diving death.

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