Updated review of postmortem biochemical exploration of hypothermia with a presentation of standard strategy of sampling and analyses

TitreUpdated review of postmortem biochemical exploration of hypothermia with a presentation of standard strategy of sampling and analyses
Type de publicationArticle de revue
AuteurRousseau, Guillaume, Reynier, Pascal , Jousset, Nathalie , Rougé-Maillart, Clotilde , Palmiere, Cristian
EditeurDe Gruyter
TypeArticle scientifique dans une revue à comité de lecture
Année2018
LangueAnglais
Date1er Mai 2018
Numéro11
Pagination1819-1827
Volume56
Titre de la revueClinical chemistry and laboratory medicine
ISSN1437-4331
Mots-clésbiochemistry, Biomarkers, forensic, Hypothermia, postmortem
Résumé en anglais

Hypothermia is defined as a core body temperature below 35°C and can be caused by environmental exposure, drug intoxication, metabolic or nervous system dysfunction. This lethal pathology with medico-legal implications is complex to diagnose because macroscopic and microscopic lesions observed at the autopsy and the histological analysis are suggestive but not pathognomonic. Postmortem biochemical explorations have been progressively developed through the study of several biomarkers to improve the diagnosis decision cluster. Here, we present an updated review with novel biomarkers (such as catecholamines O-methylated metabolites, thrombomodulin and the cardiac oxyhemoglobin ratio) as well as some propositional interpretative postmortem thresholds and, to the best of our knowledge, for the first time, we present the most adapted strategy of sampling and analyses to identify biomarkers of hypothermia. For our consideration, the most relevant identified biomarkers are urinary catecholamines and their O-methylated metabolites, urinary free cortisol, blood cortisol, as well as blood, vitreous humor and pericardial fluid for ketone bodies and blood free fatty acids. These biomarkers are increased in response either to cold-mediated stress or to bioenergetics ketogenesis crisis and significantly contribute to the diagnosis by exclusion of death by hypothermia.

URL de la noticehttp://okina.univ-angers.fr/publications/ua18753
DOI10.1515/cclm-2018-0153
Lien vers le document

https://www.degruyter.com/view/j/cclm.2018.56.issue-11/cclm-2018-0153/cc...

Titre abrégéClin. Chem. Lab. Med.
Identifiant (ID) PubMed29715177