Effects of Acquisition of Blood Specimens on Drug Levels and the Effects of Transportation Coditions on Degradation of Drugs.

摘要

The collection site and manner in which postmortem blood is collected and shipped to the reference laboratory in a forensic pathology autopsy setting may significantly impact toxicological results due to possible degradation of specimen or postmortem re-distribution (PMR). Generally, heart blood and peripheral blood specimens are collected; heart blood is often used for screening, while peripheral blood concentrations may help facilitate interpretation. Some offices perform an external blind stick of the inguinal region assuming the collection is from the femoral vein. Others rely on direct visual stick of the common iliac vein once the abdominal/pelvic cavity is opened. The assumption is that the method of acquisition does not influence drug concentration. Few studies have examined the influence of specimen collection and shipping procedures on postmortem drug concentration. We examined three different peripheral blood specimen collection/shipping procedures in order to determine whether significant differences in drug concentration could be detected. Femoral blood (Specimen 1) was obtained by blind stick of the femoral vein in the area of the inguinal region and shipped to the laboratory at ambient temperature. A second blood specimen (Specimen 3) was obtained by a blind stick of the same side femoral vein in the inguinal region and was shipped to the reference laboratory on dry ice. Iliac blood (Specimen 2) was collected by direct visualization and clamping of the opposite side iliac vein (after opening the abdominal cavity) and shipped to the laboratory on dry ice. variance