Distribution of etomidate in a fatal intoxication

Area of Science:

• Forensic Toxicology
• Clinical Pharmacology

Background:

• Etomidate is a widely used anesthetic for induction due to its hemodynamic stability.
• Its utility in trauma and unstable patients makes it relevant for postmortem analysis.

Observation:

• This case presents etomidate concentrations in femoral blood (0.40 mg/L), bile (0.46 mg/L), and vitreous (0.30 mg/L) from a suicide.
• These levels are substantially higher than those observed in two trauma resuscitation cases (<0.026 mg/L and 0.05 mg/L).

Findings:

• Novel data on etomidate concentrations in biological fluids and tissues are reported.
• The reported concentrations in the suicide case are significantly elevated compared to therapeutic or resuscitation levels.

Implications:

• Establishes critical reference values for etomidate in forensic investigations.
• Aids toxicologists in interpreting etomidate levels in postmortem drug screening.