International Journal of Legal Medicine

, Volume 111, Issue 1, pp 22–26

Genesis and diagnostic value of leukocyte and platelet accumulations around “air bubbles” in blood after venous air embolism

  • S. Ritz-Timme
  • N. Eckelt
  • E. Schmidtke
  • H. Thomsen
Original article

DOI: 10.1007/s004140050105

Cite this article as:
Ritz-Timme, S., Eckelt, N., Schmidtke, E. et al. Int J Leg Med (1997) 111: 22. doi:10.1007/s004140050105

Abstract

Leukocyte and platelet accumulations around apparently empty spaces (“air bubbles”) in the blood of the right heart or branches of the pulmonary artery should constitute histomorphological evidence of a venous air embolism prior to death. Such findings have been evaluated as the result of active cellular reactions to air bubbles and as a vital reaction. This interpretation was reviewed by injecting a frothy mixture of blood and air into the pulmonary artery of six human lungs 12–110 h post mortem. The lungs were fixed and (immuno)histologically prepared (haematoxylin-eosin staining, immunohistological visualization of platelets, fibrinogen and fibrin). Leukocyte and platelet accumulations around “air bubbles” in blood were provoked late post mortem by injection of the frothy blood-air mixture and are thus possibly not the result of vital cellular reactions. The case is rather that attachment of particles (cells) to flowing air bubbles in an aqueous medium (blood) could correspond physicochemically to a flotation process such as those used in industry for separation techniques. A flotation process would, however, require an intensive dynamic blood-air bubble contact, which would only be obtainable if cardiac action is maintained for a sufficient length of time after air embolism. Leukocyte and platelet accumulations around “air bubbles” in the blood would then indeed be properly interpreted as a vital reaction (albeit possibly not resulting from vital cellular reactions) and could be used as evidence of an air embolism prior to death.

Key words Venous air embolism Histomorphological evidence Flotation Vital reaction 

Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • S. Ritz-Timme
    • 1
  • N. Eckelt
    • 1
  • E. Schmidtke
    • 1
  • H. Thomsen
    • 1
  1. 1.Institut für Rechtsmedizin, Christian-Albrechts-Universität zu Kiel, Arnold-Heller-Strasse 12, D-24105 Kiel, Germany FAX: +49 (431) 597 3612DE

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