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Possible postmortem serum markers for differentiation between fresh-, saltwater drowning and acute cardiac death: a preliminary investigation.

Abstract
The aim of the present study was to investigate the differences in postmortem blood biochemistry between fresh-, saltwater drowning and acute myocardial infarction/ischemia (AMI) (n=11, n=15 and n=23, respectively; postmortem interval <48 h). Left and right cardiac blood samples were examined for the serum markers: sodium (Na), chloride (Cl), magnesium (Mg), blood urea nitrogen (BUN), creatinine (Cr), pulmonary surfactant-associated protein A (SP-A) and cardiac troponin T (cTn-T). The most efficient markers were the left-right cardiac BUN ratio for determination of drowning (hemodilution) and the left heart blood Mg level for differentiation between fresh- and saltwater aspiration. A characteristic feature of saltwater drowning was a low left-right BUN ratio and a marked elevation in the serum Cl, Mg and Ca levels of the left heart blood. Serum cTn-T level was usually low in drownings, showing a difference from most cases of AMI. Freshwater drowning showed a significant elevation of serum SP-A, although there was considerable overlapping with saltwater drowning and AMI. These findings suggested the usefulness of serum markers in the investigation of death from drownings.
AuthorsBao-Li Zhu, Kaori Ishida, Mari Taniguchi, Li Quan, Shigeki Oritani, Kohei Tsuda, Yasunobu Kamikodai, Masaki Q Fujita, Hitoshi Maeda
JournalLegal medicine (Tokyo, Japan) (Leg Med (Tokyo)) Vol. 5 Suppl 1 Pg. S298-301 (Mar 2003) ISSN: 1344-6223 [Print] Ireland
PMID12935616 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Biomarkers
  • Chlorides
  • Pulmonary Surfactant-Associated Protein A
  • Troponin T
  • Magnesium
  • Calcium
Topics
  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers (blood)
  • Blood Urea Nitrogen
  • Calcium (blood)
  • Child
  • Child, Preschool
  • Chlorides (blood)
  • Diagnosis, Differential
  • Drowning (blood, diagnosis)
  • Female
  • Fresh Water
  • Humans
  • Infant
  • Infant, Newborn
  • Magnesium (blood)
  • Male
  • Middle Aged
  • Myocardial Infarction (blood, diagnosis)
  • Pulmonary Surfactant-Associated Protein A (blood)
  • Seawater
  • Troponin T (blood)

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