Postmortem blood sampling-Comparison of drug concentrations at different sample sites
B Zilg1, G Thelander2, B Giebe1
1Swedish National Board of Forensic Medicine, Retzius väg 5, 171 65 Solna, Sweden.
Postmortem redistribution causes drug concentrations to vary by blood sample site. Forensic analysis should prioritize peripheral venous blood collected soon after death to ensure accurate drug concentration measurements.
Area of Science:
- Forensic Toxicology
- Postmortem Medicine
- Pharmacokinetics
Background:
- Drug concentrations in postmortem blood samples are known to vary significantly due to postmortem redistribution.
- Understanding these variations is crucial for accurate toxicological analysis in forensic investigations.
Purpose of the Study:
- To investigate the impact of sampling site on drug concentrations in postmortem blood.
- To evaluate the influence of drug properties (volume of distribution) and postmortem interval (PMI) on redistribution patterns.
- To provide recommendations for optimal postmortem blood sampling in forensic toxicology.
Main Methods:
- Blood samples were collected from multiple sites (heart, carotid artery, jugular vein, iliac artery, iliac vein) during autopsy in 48 suspected intoxication cases.
- Drug concentrations were analyzed, and ratios between different sampling sites were calculated.
- Data were analyzed in relation to drug volume of distribution and postmortem interval (PMI).
Main Results:
- Central blood samples (heart) showed higher drug concentrations than peripheral samples (iliac vein) (mean ratio 1.3).
- Arterial blood samples had higher concentrations than venous samples (carotid/jugular ratio 1.4; iliac artery/vein ratio 1.3).
- Drugs with a high volume of distribution and longer postmortem intervals exhibited greater redistribution, with arterial/venous ratios reaching 2.0 in cases with long PMI.
Conclusions:
- Drug concentrations in postmortem blood are significantly affected by sample site and postmortem interval.
- Peripheral venous blood samples, when available, are preferable for toxicological analysis.
- Sampling as early as possible after death is recommended to minimize redistribution effects and ensure reliable results.
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