[Validity of digoxin concentrations in blood determined post mortem (author's transl)]

The digoxin concentration in the blood of ten patients with terminal illness were determined by radioimmunoassay sampling the specimens 10-30 min before death, 30 min after death (subclavial catheter), and at autopsy (femoral vein and heart). At autopsy increased levels were found: in heart blood 6.64 +/- 4.45 ng/ml, in femoral vein blood 4.42 +/- 2.45 ng/ml, in ante mortem vein blood 3.36 +/- 1.75 ng/ml, mean difference in vein blood: 1.06 +/- 0.79 ng/ml (mean value and standard deviation). Only the corresponding concentration values in vein blood are closely correlated. The increase is determined statistically significant by the initial concentration found before death. A gradient dependent diffusion back from the tissues surrounding the vessels is to be considered. The walls of the vessels, however, do not contain higher digoxin concentration than the blood. Six of the ten cases showed levels of digoxin in the ante mortem blood clearly above the therapeutic range of 0.5-2.0 ng/ml. Reasons for this observation are discussed.