Postmortem Alcohol Interpretation

摘要: Ethyl alcohol (EA), the psychoactive ingredient in “alcoholic beverages,” is ubiquitous globally, and intemperate consumption commonly associated with violence disease. The most frequently detected drug by toxicology laboratories, it leading cause of drug-associated death nonfatal trauma. As a central nervous system depressant, acutely impairs human function produces consistently documented, measurable neurophysiologic changes at advancing stages intoxication. pharmacokinetics EA (absorption, distribution, elimination) subject to multiple variables. Tolerance from habitual critically impacts evaluation both behavioral change biochemical features. Toxicity chronic causes multiorgan pathology considerable morbidity mortality. Toxicologists have quantified virtually all bodily organs, tissues, secretions. Whole blood femoral or subclavian veins analytical “gold standard” for official medicolegal investigation. Many studies established comparative ratio concentration (BAC) matrices extravascular compartments. Postmortem decomposition spuriously increases owing endogenous production overgrowth normal, fermentative flora gut substantial (−0.20%) artifactual elevations. Vitreous humor, typically sterile, reliable comparison medium differentiate antemortem postmortem production. Fluids embalmed bodies may be utilized selectively estimate BAC constitutive volatiles embalming fluid. Characteristic gross histological various organ systems diagnostic alcoholism even without history. Progressive toxic effects are expressed liver, heart, pancreas, system. Clinically, many non-alcohol-related medical drug-related conditions mimic acute investigator required interpret results specimens survivor responsible deaths vehicular collisions. For this reason review also addresses issues related collection processing living persons. Application retrograde analysis extrapolation time prior cautiously considered only when clearly elimination phase. These estimations rely not on type timing collected specimens, but factors such as individual’s physiology, alcoholic beverage consumed, length circumstances drinking period. In investigations, invariably future evidentiary relevance materiality. Strict observance legal chain custody obtained deceased survivors mandatory guarantee reliability integrity which forensic pathologist interpretative toxicologist relies. Properly recognized, obtained, packaged, transmitted, analyzed, stored facilitate admissibility valid expert interpretation court.