POSTMORTEM REDISTRIBUTION AND INTERPRETATION OF BLOOD CONCENTRATIONS

Year 2017, Volume: Volume 2 Issue: İssue 1 (1) - 2.İnternational Congress Of Forensic Toxicology, 114 - 114, 16.02.2017

Hülya Koyuncu

Abstract

One of the most
difficult responsibilities of the forensic toxicologist is the interpretation
of postmortem drug levels (therapeutic, toxic, or lethal). The drug levels are
generally assessed in the light of the blood concentration. Postmortem
redistribution (PMR) is one of many factors (hydrolysis, bacterial activity,
blood coagulation and hypostasis or movement of the cadaver before sampling)
that may lead to changes in drug concentrations after death. As the interval
between death and collection of blood samples becomes longer, drugs from
tissues and organs that contain high drug concentrations redistribute due to
cadaver decomposition. Thus, drug concentrations increase in the blood.
Mechanisms of PMR may also be affected by a particular drug’s characteristics,
such as lipophilicity, volume of distribution, and pH status (acidic, basic, or
neutral). For example, basic, highly lipophilic drugs with a volume of
distribution greater than 3 L/kg are particularly susceptible to PMR. Although
the presence of PMR is a well-recognized phenomenon in forensic toxicology, it
is still under-explored and systematic studies on PMR are rare. For most drugs,
femoral blood is regarded as the optimal sample for interpretation based on its
greater distance from organs that may be influenced by PMR mechanisms. However,
blood samples taken from different sites such as heart blood, femoral, iliac or
subclavian blood, head or hematoma blood should be clearly identified on test
tubes and blood from different sites should never be combined. This is very
important to interpretation of blood concentrations.

Keywords

POSTMORTEM REDISTRIBUTION AND INTERPRETATION OF BLOOD CONCENTRATIONS

References

• Hülya KOYUNCU
• Hitit University, Faculty of Engineering, Chemical Engineering Department, Çorum, 19030, Turkey