Postmortale Umverteilung; Intoxikation; Feststellung der Todesursache; CT-gestützte Probennahme; Flüssigchromatographie-Massenspektrometrie
Staeheli Sandra N, Boxler Martina I, Oestreich Andrea, Marti Michelle, Gascho Dominic, Bolliger Stephan A, Kraemer Thomas, Steuer Andrea E (2017), Postmortem distribution and redistribution of MDAI and 2-MAPB in blood and alternative matrices, in Forensic Sci Int.
, 279, 83-87.
Staeheli Sandra N, Gascho Dominic, Ebert Lars C, Kraemer Thomas, Steuer Andrea E (2017), Time-dependent postmortem redistribution of morphine and its metabolites in blood and alternative matrices-application of CT-guided biopsy sampling, in Int J Legal Med.
, 131(2), 379-389.
Staeheli Sandra N, Baumgartner Markus R, Gauthier Saskia, Gascho Dominic, Jarmer Juliane, Kraemer Thomas, Steuer Andrea E (2016), Time-dependent postmortem redistribution of butyrfentanyl and its metabolites in blood and alternative matrices in a case of butyrfentanyl intoxication, in Forensic Sci Int.
, 266, 170-177.
Brockbals Lana, Staeheli Sandra N, Gascho Dominic, Ebert Lars C, Kraemer Thomas, Steuer Andrea E, Time-dependent postmortem redistribution of opioids in blood and alternative matrices, in J Anal Tox
Elucidation of the cause of death is one of the main reasons for medico-legal investigations. It is not only important for police or state attorneys but also for relatives of the deceased and beloved person. Often, it helps relatives to finally cope with their loss. In forensic toxicology, the severity of a given poisoning is typically assessed in the light of the blood concentration of a pharmacologically or toxicologically active compound (or “xenobiotic”) involved in a case. Reference values such as “therapeutic”, “toxic”, or “lethal” levels usually exist only in living people. However, numerous biochemical and biological processes begin immediately after death (among others: pH changes, lysis of cells and membranes, etc.) that may render unreliable the calculated drug concentration. Blood concentrations can massively decrease or increase after death e.g. due to bacterial degradation or formation, drug instability or due to postmortem redistribution. Therefore, interpretation of blood levels as “therapeutic”, “toxic” or even “lethal” cannot simply be translated from living reference values to postmortem cases. A major drawback still is the lack of fundamental, systematic human data on the described phenomena and there is an urgent need for further studies. With new technologies available (robotized biopsies under computed tomography (CT)-control and new ultra-wide dynamic range LC-MS/MS methods) and integration of the sampling in the routine workflow, more systematic studies are finally possible. Repeated sampling at two different time-points after death not only in body fluids, but also in various tissues and organs and comparison of time and site-dependent drug concentration changes could provide deeper insights into the underlying mechanisms of postmortem redistribution. This knowledge should massively improve forensic toxicological interpretation of postmortem cases in the future.