Evaluation of post-mortem oxymetry in fire victims

In order to investigate the pathophysiology of death due to fires, we examined blood samples of 48 fire victims on CO-oximeter systems and evaluated the oxymetric differences between arterial and venous blood as well as those between the heart and peripheral blood. Post-mortem carboxyhemoglobin (CO-Hb) levels in the left and right heart blood, respectively, ranged from 1.2 to 94.7% and from 0.4 to 90.5%. Marked arterio-venous and centro-peripheral differences were observed in the cases of high CO-Hb (above ca. 70%), suggesting an immediate effect of fatal carbon monoxide (CO) poisoning probably accompanied with acute heart failure. A relatively high oxyhemoglobin level was observed in the cases of low CO-Hb (below ca. 30%). In some cases, reduced hemoglobin levels in the left heart blood were paradoxically somewhat higher than those in the right. These oxymetric profiles may assist to consider the final balance of blood gas in fire victims depending on increased CO, carbon dioxide, and reduction of oxygen in the ambient atmosphere due to combustion, although post-mortem interference should be taken into consideration.