Marker of death from hemorrhagic shock

Hemorrhagic shock has often been cited as a cause of death in forensic practical cases, but it is usually difficult to prove by autopsy findings alone. Our experimental studies demonstrated that hemorrhagic shock has promoted the endovascular recruitment of activated neutrophils and finally led to dysfunction of the shock organs. In this study, activated neutrophils were studied as a marker of death from hemorrhagic shock in the organs of autopsy cases in our department. Morphological changes in the heart, lung, liver, and kidney were examined in cases of death from hemorrhagic shock. The frequency of appearance of activated neutrophils was measured by immunohistochemical staining in the organs. The commonly observed morphological changes of hemorrhagic shock, which were not always expressed in any cases, could not account well for the cause of death. However, the expression of activated neutrophils in the organs elevated significantly at a middle and long antemortem interval. The appearance of activated neutrophils in the shock organs might be useful as a morphological marker of the cause of death from hemorrhagic shock in forensic practice cases.