International Journal of Legal Medicine

, Volume 127, Issue 2, pp 437–445 | Cite as

Differentiation at autopsy between in vivo gas embolism and putrefaction using gas composition analysis

  • Yara Bernaldo de Quirós
  • Oscar González-Díaz
  • Andreas Møllerløkken
  • Alf O. Brubakk
  • Astrid Hjelde
  • Pedro Saavedra
  • Antonio Fernández
Original Article

Abstract

Gas embolism can arise from different causes (iatrogenic accidents, criminal interventions, or diving related accidents). Gas analyses have been shown to be a valid technique to differentiate between putrefaction gases and gas embolism. In this study, we performed systematic necropsies at different postmortem times in three experimental New Zealand White Rabbits models: control or putrefaction, infused air embolism, and compression/decompression. The purpose of this study was to look for qualitative and quantitative differences among groups and to observe how putrefaction gases mask in vivo gas embolism. We found that the infused air embolism and compression/decompression models had a similar gas composition prior to 27-h postmortem, being typically composed of around 70–80 % of N2 and 20–30 % of CO2, although unexpected higher CO2 concentrations were found in some decompressed animals, putting in question the role of CO2 in decompression. All these samples were statistically and significantly different from more decomposed samples. Gas composition of samples from more decomposed animals and from the putrefaction model presented hydrogen, which was therefore considered as a putrefaction marker.

Keywords

Putrefaction Gas embolism Decompression Gas composition Nitrogen 

Notes

Acknowledgments

The authors would like to thank all colleagues from the University of Las Palmas de Gran Canaria (Spain) who contributed to this work and to the hyperbaric medicine division of the Norwegian University of Science and Technology (Norway) for its scientific contribution. We would also like to thank Dr. Jose Luis Martín Barrasa for his help during the animal experiments at the Unit of Research of the Negrín Hospital in Spain. This work was supported by the Spanish Ministry of Science and Innovation with two research projects, (AGL 2005-07947) and (CGL 2009/12663), as well as the Government of Canary Islands (DG Medio Natural). The Spanish Ministry of Education contributed with personal financial support (the University Professor Formation fellowship). The Central Norway Regional Health Authority and the Norwegian University of Science and Technology supported additionally the hyperbaric experiment. Finally, The Woods Hole Oceanographic Institution Marine Mammal Centre and Wick and Sloan Simmons provided funding for the latest stage of this work.

Conflict of interest

The authors declare no conflict of interest.

Animal welfare

The study was performed in accordance with all EU applicable laws, regulations, and standards, obtaining the corresponding approval from the different ethical committees.

Supplementary material

414_2012_783_Fig6_ESM.jpg (33 kb)
Supplemental Fig. 1

Intestinal gas sample composition from the putrefaction model vs. PM time illustrating the contribution of each gas to the total amount in percentage μmol. (JPEG 33 kb)

414_2012_783_MOESM1_ESM.tif (433 kb)
High Resolution Image (TIFF 432 kb)
414_2012_783_Fig7_ESM.jpg (38 kb)
Supplemental Fig. 2

Intestinal gas sample composition from the AE model vs. PM time illustrating the contribution of each gas to the total amount in percentage μmol. (JPEG 37 kb)

414_2012_783_MOESM2_ESM.tif (490 kb)
High Resolution Image (TIFF 489 kb)
414_2012_783_Fig8_ESM.jpg (26 kb)
Supplemental Fig. 3

Intestinal gas sample composition from the compression/decompression model vs. PM time illustrating the contribution of each gas to the total amount in percentage μmol. (JPEG 26 kb)

414_2012_783_MOESM3_ESM.tif (409 kb)
High Resolution Image (TIFF 408 kb)

References

  1. 1.
    Muth CM, Shank ES (2000) Primary care: gas embolism. N Engl J Med 342(7):476–482PubMedCrossRefGoogle Scholar
  2. 2.
    Knight B (1996) Forensic pathology. Edward Arnold, LondonGoogle Scholar
  3. 3.
    Hamilton RW, Thalmann ED (2003) Decompression practice. In: Brubakk AO, Neuman TS (eds) Bennett and Elliott's physiology and medicine of diving. Saunders, pp 455-500Google Scholar
  4. 4.
    Vann RD, Butler FK, Mitchell SJ, Moon RE (2011) Decompression illness. Lancet 377(9760):153–164. doi: 10.1016/s0140-6736(10)61085-9 PubMedCrossRefGoogle Scholar
  5. 5.
    Pierucci G (1985) The post-mortem diagnosis of gas embolism. Pathologica (Genoa) 77(1048):145–156Google Scholar
  6. 6.
    Richter M (1905) Gerichtsärztliche Diagnostik und Technik. S. Hirzel, LeipzigGoogle Scholar
  7. 7.
    Keil W, Bretsxhneider K, Patzelt D, Behning I, Lignitz E, Matz J (1980) Luftembolie oder Fäulnisgas? Zur Dianostik der cardialen Luftembolie an der Leiche. Beiträge zur Gerichtlichen Medizin 38:395–408PubMedGoogle Scholar
  8. 8.
    Bajanowski T, Kohler H, DuChesne A, Koops E, Brinkmann B (1998) Proof of air embolism after exhumation. Int J Legal Med 112(1):2–7CrossRefGoogle Scholar
  9. 9.
    Kuiken T, García-Hartmann M Dissection techniques and tissues sampling. In: Newsletter (ed) 1st European cetacean society workshop on cetacean pathology, Leiden, Netherlands, 1991Google Scholar
  10. 10.
    Pierucci G, Gherson G (1969) Further contribution to the chemical diagnosis of gas embolism. The demonstration of hydrogen as an expression of “putrefactive component”. Zacchia 5(4):595–603PubMedGoogle Scholar
  11. 11.
    Pierucci G, Gherson G (1968) Experimental study on gas embolism with special reference to the differentiation between embolic gas and putrefaction gas. Zacchia 4(3):347–373PubMedGoogle Scholar
  12. 12.
    Bert P (1878) La Pression Barometrique: Recherches de Physiologie Expérimentale. (Barometric pressure: researches in experimental physiology) (trans: Hitchcock MA, Hitchcock FA). Masson, ParisGoogle Scholar
  13. 13.
    Lawrence C (1997) Interpretation of gas in diving autopsies. S Pac Underw Med Soc J 27(4):228–230Google Scholar
  14. 14.
    Bernaldo de Quirós Y, González-Díaz Ó, Saavedra P, Arbelo M, Sierra E, Sacchini S, Jepson PD, Mazzariol S, Di Guardo G, Fernández A (2011) Methodology for in situ gas sampling, transport and laboratory analysis of gases from stranded cetaceans. Sci Rep 1:193. doi: 10.1038/srep00193 Google Scholar
  15. 15.
    Hastie T, Tibshirani R, Friedman J (2009) The elements of Statistical learning: data mining, inference and prediction. Springer series in statistics, 2nd edn. Springer, New York, USAGoogle Scholar
  16. 16.
    Laird NM, Ware JH (1982) Random-effects models for longitudinal data. Biometrics 38(4):963–974. doi: 10.2307/2529876 PubMedCrossRefGoogle Scholar
  17. 17.
    R-Develpment-Core-Team (2012) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, AustriaGoogle Scholar
  18. 18.
    Hellebrekers LJ, deBoer EJW, vanZuylen MA, Vosmeer H (1997) A comparison between medetomidine-ketamine and medetomidine-propofol anaesthesia in rabbits. Lab Anim 31(1):58–69PubMedCrossRefGoogle Scholar
  19. 19.
    Smith-Sivertsen J The origin of intravascular bubbles produced by decompression of rats killed prior to hypebaric exposure. In: Lambertsen CJ (ed) Proceedings of the fifth symposium on underwater physiology, Washington, DC, 1976. Bethesda MD, pp 303-309Google Scholar
  20. 20.
    Ishiyama A, Mano Y, Shibayama M, Maeda H (1981) Analysis of gas composition of dysbaric decompressed bubble. In: Miller JW (ed) The sixth meeting of the panel on diving physiology and technology. The United States–Japan Cooperative Program in Natural Resources, California, U.S.A., pp 201-210Google Scholar
  21. 21.
    Ishiyama A (1983) Analysis of gas composition of intra vascular bubbles produced by decompression. Bull Tokyo Med Dent Univ 30(2):25–36PubMedGoogle Scholar
  22. 22.
    Armstrong HG (1939) Analysis of gas emboli. Engineering Section Memorandum Report. Wright Field, OhioGoogle Scholar
  23. 23.
    Harris M, Berg WE, Whitaker DM, Twitty VC, Blinks LR (1945) Carbon dioxide as a facilitating agent in the initiation and growth of bubbles in animals decompressed to simulated altitudes. J Gen Physiol 28(3):225–240PubMedCrossRefGoogle Scholar
  24. 24.
    Behnke AR (1951) Decompression sickness following exposure to high pressures. In: Fulton JF (ed) Decompression sickness. Saunders, Phyladelphia, pp 53-89Google Scholar
  25. 25.
    Berghage TE, Keating LJ, Wooley JM (1978) Decompression sickness in rats and mice rapidly decompressed after breathing various concentrations of carbon dioxide. In: Lambertsen CJ (ed) Proceedings of the sixth underwater physiology symposium, vol 6. Bethesda, pp. 485–496Google Scholar
  26. 26.
    Harvey EN (1945) Decompression sickness and bubble fromation in blood and tissues. Bulletin of the New York Academy of Medicine 21:505–536Google Scholar
  27. 27.
    Guyton AC (1981) Physical principles of gaseous exchange; diffusion of oxygen and carbon dioxide through the respiratory membrane. In: Textbook of medical physiology. 6th edn. W.B. Saunders, Philadelphia, pp 491-503Google Scholar
  28. 28.
    Dean RB (1944) The formation of bubbles. J Appl Phys 15(5):446–451CrossRefGoogle Scholar
  29. 29.
    Chappell MA, Payne SJ (2006) A physiological model of gas pockets in crevices and their behavior under compression. Respir Physiol Neurobiol 152(1):100–114. doi: 10.1016/j.resp.2005.07.010
  30. 30.
    Francis TJR, Simon JM (2003) Pathology of Decompression Sickness. In: Brubakk AO, Neuman TS (eds) Bennett and Elliott's physiology and medicine of diving. Saunders, pp 530-556Google Scholar
  31. 31.
    Davies JM (1983) Studies on bubble formation after decompression: with special reference to the development and testing of the integrating ultrasonic pulse-echo imaging system for bubble detection. University of Oxford, OxfordGoogle Scholar
  32. 32.
    Blatteau JE, Souraud JB, Gempp E, Boussuges A (2006) Gas nuclei, their origin, and their role in bubble formation. Aviation Space and Environmental Medicine 77:1068–1076Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Yara Bernaldo de Quirós
    • 1
    • 5
  • Oscar González-Díaz
    • 2
  • Andreas Møllerløkken
    • 3
  • Alf O. Brubakk
    • 3
  • Astrid Hjelde
    • 3
  • Pedro Saavedra
    • 4
  • Antonio Fernández
    • 1
  1. 1.Veterinary Histology and Pathology, Department of Morphology, Institute of Animal Health, Veterinary SchoolUniversity of Las Palmas de Gran Canaria (ULPGC)Las PalmasSpain
  2. 2.Physical and Chemical Instrumental Center for the Development of Applied Research Technology and Scientific estate (CIDIA), Edificio Polivalente 1University of Las Palmas de Gran Canaria (ULPGC)Las PalmasSpain
  3. 3.Department of Circulation and Medical ImagingNorwegian University of Science and TechnologyTrondheimNorway
  4. 4.Department of MathematicsUniversity of Las Palmas de Gran Canaria (ULPGC)Las PalmasSpain
  5. 5.Biology DepartmentWoods Hole Oceanographic InstitutionWoods HoleUSA

Personalised recommendations