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Related Experiment Videos

Fatal intoxications with chloral hydrate.

J M Gaulier1, G Merle, E Lacassie

  • 1Department of Pharmacology and Toxicology, University Hospital, Limoges, France.

Journal of Forensic Sciences
|November 21, 2001
PubMed
Summary

Chloral hydrate (CH) syrup can cause fatal intoxication, leading to coma and respiratory arrest, even in patients with alcohol dependence. Toxicological analysis confirmed CH and its metabolite, trichloroethanol, in fatal cases.

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Area of Science:

  • Toxicology
  • Pharmacology
  • Clinical Chemistry

Background:

  • Chloral hydrate (CH) is a sedative-hypnotic historically used for insomnia and anxiety.
  • Dependence on CH, particularly in individuals with alcohol use disorder, presents unique clinical challenges.
  • Understanding CH toxicity is crucial for effective patient management and forensic investigation.

Observation:

  • Two cases of fatal chloral hydrate (CH) intoxication are presented.
  • Case 1: An alcoholic man dependent on CH presented with coma and respiratory arrest, succumbing to cerebral edema.
  • Case 2: A woman with alcohol addiction, depression, and epilepsy experienced cardiorespiratory failure after CH absorption, leading to deep coma and death.

Findings:

  • Toxicological analysis confirmed CH and its primary metabolite, trichloroethanol (TCE), in serum and urine of both patients.

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  • Headspace-capillary gas chromatography-mass spectrometry (HS-GC-MS) was employed for accurate identification and quantification.
  • Measured concentrations were comparable to those reported in previous fatal CH intoxication cases.

    • Implications:

    • The presented analytical method (HS-GC-MS) is suitable for diagnosing CH intoxication in both clinical and forensic settings.
    • This study highlights the severe risks associated with CH dependence and overdose.
    • Accurate toxicological screening is vital for managing CH poisoning and determining cause of death.