Postmortem diagnosis of sepsis.
Human sepsis is a spectrum of pathophysiological changes in the host system resulting from a generalized activation and systemic expression of the host's inflammatory pathways in response to infection. Since autopsy findings and routine histology in cases of suspected fatal sepsis are most often unspecific and unconvincing, a number of studies has recently dealt with different methods and markers to better define criteria for the postmortem diagnosis of sepsis. Research carried out on specimens obtained postmortem from sepsis-associated fatalities is an important tool to improve our understanding of inflammatory organ changes and the associated underlying pathophysiological mechanisms. One pitfall the investigator has to be aware of is how to select appropriate case material that constitutes the basis for the setting-up of reference values that derive from such studies. Since no scientific studies have investigated the value of cardiac blood samples in the present context, autopsy blood samples for the determination of biochemical sepsis markers have to derive from the femoral vein. In both sepsis cases as well as controls, the time of death has to be well defined.
Tsokos
Michael
M
Institute of Legal Medicine, Department of Forensic Pathology, University Hospital Hamburg-Eppendorf, Butenfeld 34, D-22529 Hamburg, Germany. mtsokos@web.de
D015415:Biomarkers / Q000378:metabolism; D019040:E-Selectin / Q000378:metabolism; D042783:Endothelial Cells / Q000378:metabolism; D049429:Forensic Pathology / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D039041:Integrin alpha4beta1 / Q000378:metabolism; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D007781:Lactoferrin / Q000378:metabolism; D007962:Leukocytes / Q000378:metabolism; D011180:Postmortem Changes; D018805:Sepsis / Q000175:diagnosis* / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D015415:Biomarkers; D019040:E-Selectin; D039041:Integrin alpha4beta1; D042461:Vascular Endothelial Growth Factor A; D018799:Intercellular Adhesion Molecule-1; D007781:Lactoferrin