Proof of fatal air embolism

Bajanowski, Thomas; West, Alex; Brinkmann, B.

doi:10.1007/s004140050153

Cited by 54 publications

(36 citation statements)

References 15 publications

(18 reference statements)

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“…This venous air embolism is transported into the right cardiac atrium and ventricle, where it mixes with blood during cardiac contraction. The gas bubbles can then block blood circulation by filling pulmonary arteries and/or the right atrium and ventricle, which leads to heart failure [20]. In conventional autopsy, the diagnosis of air embolism requires a special examination technique.…”

Section: Introductionmentioning

confidence: 99%

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Distribution of artifactual gas on post-mortem multidetector computed tomography (MDCT)

et al. 2011

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Purpose We investigated the incidence and distribution of post-mortem gas detected with multidetector computed tomography (MDCT) to identify factors that could distinguish artifactual gas from cardiac air embolism. Material and methods MDCT data of 119 cadavers were retrospectively examined. Gas was semiquantitatively assessed in selected blood vessels, organs, and body spaces (82 total sites). Results Seventy-four of the 119 cadavers displayed gas (62.2%; CI 95% 52.8-70.9), and 56 (75.7%) displayed gas in the heart. Most gas was detected in the hepatic parenchyma (40%), right heart (38% ventricle, 35% atrium), inferior vena cava (30% infrarenally, 26% suprarenally), hepatic veins (26% left, 29% middle, 22% right), and portal spaces (29%). Male cadavers displayed gas more frequently than female cadavers. Gas was detected 5-84 hours after death; therefore, the post-mortem interval could not reliably predict gas distribution (rho=0.719, p<0.0001). We found that a large amount of putrefaction-generated gas in the right heart was associated with aggregated gas bubbles in the hepatic parenchyma (sensitivity=100%, specificity=89.7%). In contrast, gas in the left heart (sensitivity=41.7%, specificity=100%) or in periumbilical subcutaneous tissues (sensitivity=50%, specificity=96.3%) could not predict gas due to putrefaction. Conclusion This study is the first to show that the appearance of post-mortem gas follows a specific distribution pattern. An association between intracardiac gas and hepatic parenchymal gas could distinguish between post-mortem-generated gas and vital air embolism. We propose that this finding provides a key for diagnosing death due to cardiac air embolism.

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Section: Introductionmentioning

confidence: 99%

“…Gas composition is determined with gas chromatography, which uses a thermoconducting detector to separate oxygen, nitrogen, carbon dioxide, methane, and hydrogen. Because the composition of gas in air embolism is different from that of post-mortem gas, this method clearly distinguishes between the two [20].…”

Section: Introductionmentioning

confidence: 99%

Distribution of artifactual gas on post-mortem multidetector computed tomography (MDCT)

et al. 2011

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“…The detection of a fatal air embolism requires special precautions during autopsy [2][3][4][5][6][7][8] and the investigation should be carried out as early as possible after death [2,9]. One of the main criteria for the diagnosis of fatal air embolism is the typical gas composition detected by gas analysis;…”

Section: Introductionmentioning

confidence: 99%

Proof of air embolism after exhumation

Bajanowski

Köhler

DuChesne

et al. 1998

International Journal of Legal Medicine

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The detection, storage, and analysis of gas taken from the heart ventricle is necessary to diagnose a fatal air embolism and this requires special precautions during autopsy. When the results of gas analysis correspond to the criteria defined by Pierucci and Gherson the diagnosis "air embolism" is justified. In cases showing putrefaction the diagnostic value of gas analysis was negated. In a series of 15 patients who were assumed to have been killed by air injection in a peripheral vein the corpses were exhumed and a full medico-legal examination was carried out including gas analysis. In 8 cases results could be obtained indicating a mixture of embolised air and gases of putrefaction. In two control groups comprising 10 exhumed bodies and 30 cases showing advanced putrefaction, gas analysis showed putrefaction gases except in 5 cases with gas volumes less than 5 ml in the right ventricle. Therefore gas analysis can be helpful to diagnose fatal air embolism even in cases showing putrefaction while the diagnosis of putrefaction gases only does not exclude this diagnosis.

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“…Embolismo aéreo: En estos tipos de muerte hay que tener precaución desde un principio, es decir, mucho antes de abordarlo o incidir en el cadá-ver, puesto que pueden realizarse algunas pruebas que ayudan a evidenciar su presencia, a pesar de que estas autopsias, en su mayoría, se puedan considerar con hallazgos negativos inicialmente [38][39][40][41].…”

Section: Muerte Secundaria a Embolismosunclassified

Muerte por establecer y muerte súbita

Villa

2017

Colomb. forense

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Resumen.Propósito: este artículo se elaboró para crear conciencia en el campo forense sobre la importancia de conceptualizar claramente las muertes por establecer, aportando diferentes artículos vigentes disponibles, tomando lo más relevante y llevándolo a un contexto real. Periodo que se abarcó, origen y tipos de publicaciones: se realizó una búsqueda en bases de datos y en literatura descrita en libros forenses con información relevante sobre las muertes por establecer, tomando en cuenta un periodo entre 1908 y la actualidad con temas referentes a la muerte sú-bita en el ámbito forense y en el ámbito clínico médico. Punto de vista: en medio de la investigación forense nos vemos enfrentados a las muertes por establecer, que muchas veces son el talón de Aquiles de los investigadores forenses; la concepción y el concepto de la muerte por establecer deben estar claros desde el inicio del abordaje de caso; e incluso desde la escena de los hechos se debe tener claridad acerca de cómo se debe abordar y así determinar las causas y la manera de muerte con base en un todo como contexto final. Conclusiones: la muerte por establecer es un tipo de muerte que debe ser abordado de lo general a lo particular con unas bases sólidas, partiendo de la concepción clara del forense que asume el caso, el abordaje con metodología y progresión en pasos ordenados descritos con detalle en el protocolo de autopsia, hasta la elaboración de una conclusión.Palabras clave: muerte súbita, forense, establecer, desconocido, no identificado.

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Proof of fatal air embolism

Cited by 54 publications

References 15 publications

Distribution of artifactual gas on post-mortem multidetector computed tomography (MDCT)

Distribution of artifactual gas on post-mortem multidetector computed tomography (MDCT)

Proof of air embolism after exhumation

Muerte por establecer y muerte súbita

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