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Can subclavian blood be equated with a peripheral blood sample? A series of 50 cases

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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.

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Authors and Affiliations

  1. Aix-Marseille University, 13284, Marseille, France

    Caroline Sastre, Valérie Baillif-Couniou, Faustine Musarella, Christophe Bartoli, Julien Mancini, Marie-Dominique Piercecchi-Marti, Georges Leonetti & Anne-Laure Pelissier-Alicot

  2. Service de Médecine Légale, AP-HM, Hôpital Timone, 13385, Marseille, France

    Caroline Sastre, Valérie Baillif-Couniou, Faustine Musarella, Christophe Bartoli, Marie-Dominique Piercecchi-Marti, Georges Leonetti & Anne-Laure Pelissier-Alicot

  3. Service de Santé Publique et Information Médicale, AP-HM, Hôpital Timone, 13385, Marseille, France

    Julien Mancini

Authors
  1. Caroline Sastre
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  2. Valérie Baillif-Couniou
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  3. Faustine Musarella
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  4. Christophe Bartoli
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  5. Julien Mancini
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  6. Marie-Dominique Piercecchi-Marti
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  7. Georges Leonetti
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  8. Anne-Laure Pelissier-Alicot
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Correspondence to Caroline Sastre.

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Sastre, C., Baillif-Couniou, V., Musarella, F. et al. Can subclavian blood be equated with a peripheral blood sample? A series of 50 cases. Int J Legal Med 127, 379–384 (2013). https://doi.org/10.1007/s00414-012-0736-0

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  • DOI: https://doi.org/10.1007/s00414-012-0736-0

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