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Pulmonary Function Tests01:25

Pulmonary Function Tests

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Pulmonary Function Tests (PFTs)
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
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Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion
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Usefulness of liver function tests in postmortem samples.

Léonard Fumeaux1, Maria Pia Scarpelli1, Camilla Tettamanti2

  • 1CURML, University Center of Legal Medicine, Lausanne University Hospital, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland.

Journal of Forensic and Legal Medicine
|March 14, 2018
PubMed
Summary

Postmortem liver function tests in serum, including bilirubin and albumin, can reliably reflect antemortem levels. This suggests postmortem values are useful surrogates for assessing antemortem liver function in forensic cases.

Keywords:
AutopsyCerebrospinal fluidLiver function testsPostmortem biochemistryPostmortem serum

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Area of Science:

  • Forensic Science
  • Biochemistry
  • Clinical Chemistry

Background:

  • Liver function tests (LFTs) are crucial in clinical settings but their postmortem stability and reliability in forensic investigations are debated.
  • Previous studies on postmortem LFTs have yielded conflicting results regarding marker stability and diagnostic accuracy.

Purpose of the Study:

  • To assess the postmortem stability and reliability of key liver function markers (gamma-glutamyltransferase, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, total proteins, albumin) in serum.
  • To evaluate the utility of cerebrospinal fluid for measuring bilirubin and gamma-glutamyltransferase postmortem.

Main Methods:

  • Comparison of antemortem and postmortem serum samples from forensic cases for LFTs.
  • Measurement of total bilirubin and gamma-glutamyltransferase in cerebrospinal fluid samples.

Main Results:

  • Postmortem serum concentrations of bilirubin, total proteins, and albumin in femoral and cardiac blood reliably correlated with antemortem levels.
  • Postmortem femoral blood gamma-glutamyltransferase also showed reliable correlation with antemortem concentrations.
  • Cerebrospinal fluid demonstrated measurable bilirubin levels, but with wide and unpredictable variations, irrespective of liver disease.

Conclusions:

  • Postmortem serum markers like bilirubin, total proteins, albumin, and gamma-glutamyltransferase can serve as reliable surrogates for antemortem liver function assessment in forensic contexts.
  • Cerebrospinal fluid is not a reliable source for assessing liver function due to unpredictable bilirubin levels postmortem.