The aim of our study was to analyse several serum
biochemical markers in order to evaluate the discriminant capacity of
trace elements individually and jointly in
drowning (seawater
drowning and freshwater
drowning) and their correlation with age, sex, postmortem interval, time in water and concentrations of the
trace elements in the
drowning medium. Sixty-seven cases of
drowning (53 seawater
drownings (SWD); 14 freshwater
drownings (FWD) and 73 control cases (other
asphyxias, n=44, and other causes of death, n=29) were selected according to the scene, cause and circumstances of death, together with autopsy findings. Serum
strontium (Sr),
magnesium (Mg),
sodium (Na),
chloride (Cl),
calcium (Ca),
iron (Fe),
urea,
creatinine (Cr) and cardiac Troponine T (
cTn-T) were measured in the left ventricle (Lv), right ventricle (Rv) and peripheral blood. Lv-Rv differences for each marker and Sr, Mg, Na, Cl, Ca and Fe concentrations in the
drowning medium were determinated. Mean concentrations of Sr, Cl and Mg in both ventricles and peripheral serum and Lv-Rv differences and Ca Lv and Na Rv were significantly higher in cases of
drowning than for other causes of death. In SWD, Sr, Mg, Ca, Na and Cl were significantly higher in Lv than in Rv as a result of aspirating water. In contrast, haemodilution is evident from the significantly higher levels of Fe and
urea in Rv than in Lv in cases of SWD, and from the higher Mg and Cr levels in Rv in FWD. In the case of SWD, serum levels of Sr are confirmed as the best parameter for diagnosis, although other
trace elements may also be useful, such as the serum concentrations of Mg and Cl. In the case of FWD, the joint determination of Sr and other
biochemical markers, especially Fe, may increase correct diagnosis.