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Interpretation of postmortem vitreous concentrations of sodium and chloride
Karolinska Institute, Sweden.
Karolinska Institute, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
Karolinska Institute, Sweden.
2016 (English)In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 263, 107-113 p.Article in journal (Refereed) PublishedText
Abstract [en]

Vitreous fluid can be used to analyze sodium and chloride levels in deceased persons, but it remains unclear to what extent such results can be used to diagnose antemortem sodium or chloride imbalances. In this study we present vitreous sodium and chloride levels from more than 3000 cases. We show that vitreous sodium and chloride levels both decrease with approximately 2.2 mmol/L per day after death. Since potassium is a well-established marker for postmortem interval (PMI) and easily can be analyzed along with sodium and chloride, we have correlated sodium and chloride levels with the potassium levels and present postmortem reference ranges relative the potassium levels. We found that virtually all cases outside the reference range show signs of antemortem hypo- or hypernatremia. Vitreous sodium or chloride levels can be the only means to diagnose cases of water or salt intoxication, beer potomania or dehydration. We further show that postmortem vitreous sodium and chloride strongly correlate and in practice can be used interchangeably if analysis of one of the ions fails. It has been suggested that vitreous sodium and chloride levels can be used to diagnose drowning or to distinguish saltwater from freshwater drowning. Our results show that in cases of freshwater drowning, vitreous sodium levels are decreased, but that this mainly is an effect of postmortem diffusion between the eye and surrounding water rather than due to the drowning process, since the decrease in sodium levels correlates with immersion time. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2016. Vol. 263, 107-113 p.
Keyword [en]
Postmortem; Vitreous; Sodium; Chloride; Hypernatremia; Hyponatremia
National Category
Forensic Science
Identifiers
URN: urn:nbn:se:liu:diva-129143DOI: 10.1016/j.forsciint.2016.04.006ISI: 000375944700016PubMedID: 27105154OAI: oai:DiVA.org:liu-129143DiVA: diva2:936065
Note

Funding Agencies|Swedish National Board of Forensic Medicine; Swedish Medical Society

Available from: 2016-06-13 Created: 2016-06-13 Last updated: 2016-06-13

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Berg, Sören
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Thoracic and Vascular Surgery
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