title: Can subclavian blood be equated with a peripheral blood sample? A series of 50 cases.
abstract: If femoral blood is not available at autopsy, toxicological analyses, in particular blood ethanol measurements, are carried out on cardiac blood. This is known to be subject to major redistribution. We aimed to determine whether subclavian blood can be equated with a peripheral blood sample and could be used if femoral blood is not available. The study was based on 50 medicolegal autopsies in which we compared ethanol concentrations between subclavian blood, the different heart blood compartments (right and left cardiac blood), and femoral blood. Mechanisms that could lead to variations in concentration, i.e., postmortem redistribution and/or endogenous production, were also taken into account in interpreting the results. Ethanol concentrations were determined by headspace gas chromatography with a flame ionization detector. In each case, we recorded the circumstances of death, resuscitation attempts if any, degree of putrefaction, chest or abdominal trauma, and/or inhalation of gastric fluid in the airways. Ethanol concentrations in subclavian blood were found to be close to those in peripheral blood (p = 0.948) and were not influenced by the degree of putrefaction (r = 0.017, p = 0.904), gastric ethanol concentration (r = -0.011, p = 0.940), inhalation of gastric contents in the airways (p = 0.461), or cardiac resuscitation attempts (p = 0.368). We discuss the possible explanations for these findings and stress the value of sampling subclavian blood when femoral blood is not obtainable at autopsy.
authors: Aix-Marseille University, 13284, Marseille, France. caroline.sastre@ap-hm.fr
authors: Caroline
authors: C
authors: Sastre
authors: Valérie
authors: V
authors: Baillif-Couniou
authors: Faustine
authors: F
authors: Musarella
authors: Christophe
authors: C
authors: Bartoli
authors: Julien
authors: J
authors: Mancini
authors: Marie-Dominique
authors: MD
authors: Piercecchi-Marti
authors: Georges
authors: G
authors: Leonetti
authors: Anne-Laure
authors: AL
authors: Pelissier-Alicot
mesh_terms: D001646:Bile / Q000737:chemistry; D002492:Central Nervous System Depressants / Q000032:analysis*; D003331:Coronary Vessels; D000431:Ethanol / Q000032:analysis*; D005268:Femoral Vein; D005410:Flame Ionization; D049429:Forensic Pathology; D005766:Gastrointestinal Contents / Q000737:chemistry; D006336:Heart Massage; D006801:Humans; D011180:Postmortem Changes; D053120:Respiratory Aspiration / Q000473:pathology; D013350:Subclavian Vein; D014822:Vitreous Body / Q000737:chemistry
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol