Postmortem analyses of drugs in pericardial fluid and bone marrow aspirate

In forensic toxicology, bone marrow is often used when adequate blood samples are not available; however, pericardial fluid (PCF) has been poorly investigated. The present study comprehensively reviewed the toxicological data of blood, PCF and bone marrow aspirate (BMA) in forensic autopsy cases to investigate drug distribution. Analysis using automated gas chromatography/mass spectrometry (GC-MS) following solid/liquid phase extraction detected 36 drugs in 218 cases (8.0% among 2,724 cases examined). Drug distribution varied by drug as well as partly by case even when taken as a mixture. Most of the drugs showed overall similar distributions in right heart blood, PCF and BMA with some exceptions, however, several drugs, including phenothiazine derivatives and antidepressants, were detected at ∼1.5 times (1.2-2.0) higher levels in BMA than in right heart blood, but PCF levels were mostly equivalent to blood levels. Midazolam, propofol and thiamylal (intravenous anesthetics) were detected at a substantially lower concentration in PCF than in blood or BMA. These observations suggest that PCF and BMA are useful materials to be included in the forensic toxicological routine when blood samples are not available, as well as to investigate pharmaco-/toxicokinetics and postmortem redistribution.