一氧化碳中毒死亡高度腐败尸体COHb的检测

一氧化碳中毒死亡并不少见,尤其在北方地区的冬季较多见。此类死亡的法医学检验除了依据现场勘查和死者的体表及解剖所特有的尸体现象外,定性主要依据死者心脏血中检出碳氧血红蛋白（COHb）。对于新鲜死亡的尸体在死者的心脏中提取血液较容易,而对于高度腐败尸体由于腐败造成大量的腐败气体使心血管内压力增高腐败血液渗出心血管壁,     

大鼠血液中HbCO随吸入CO浓度和时间的变化

目的研究不同一氧化碳(carbon monoxide,CO)浓度下中毒大鼠的行为学特征、存活时间、碳氧血红蛋白(carboxyhemoglobin,HbCO)饱和度变化规律,为法医学实践中CO中毒死亡案件提供实验依据。方法将160只SD大鼠随机分为4组。自制染毒装置,使大鼠分别在CO浓度为1 250、3 750、6 250 mg/m~3及持续通入CO状态下染毒致死亡。观察不同CO浓度中毒大鼠的行为学特征,记录存活时间,采用分光光度法检测心血HbCO饱和度,并提取脑、心脏、肺、肝等器官进行组织病理学观察。结果 CO中毒大鼠的行为学特征表现为肢体瘫软、反应迟钝。随着CO浓度的升高,大鼠存活时间逐渐缩短,心血HbCO饱和度逐渐升高。在CO浓度为1 250 mg/m~3条件下,发现3例心血HbCO饱和度明显低于致死饱和度,其余各组未发现心血HbCO饱和度低于致死饱和度的情况。结论建立的不同浓度下CO中毒死亡动物模型,操作简单,重复性好,为进一步研究CO中毒及其他吸入性有毒气体的法医学研究奠定了基础。     

燃烧木炭致一氧化碳中毒自杀3例

某男,30岁。因未去上班,同事去其住处寻人,感觉有异,破门而入后发现其死于家中。现场勘验：现场为1室1厅房间,死者死于卧室床上,卧室门窗紧闭,窗帘呈拉合状态。卧室内地面见一烧烤用炭盆、两袋木炭及炭夹,炭盆内见木炭燃烧后的灰烬,卧室茶几上见5个空啤酒易拉罐,沙发上留有遗书1份。     

一氧化碳中毒致哽死1例

正1案例资料1.1简要案情张某,女,28岁。某年1月5日凌晨,被其丈夫送至某医院急诊室进行抢救,至医院时张某已无生命体征,值班大夫发现张某颈部有伤,遂报警。1.2现场勘验调查经勘查,现场为一间平房,门窗呈关闭状。室内可见一炭盆,内有燃烧的木炭。室内床边可见一蓝色塑料凳,凳腿部及周边地面上可见呕吐物。死者丈夫陈述,炭盆是张某4日晚7时多放进屋的,后其外出办事,次日0时许返回,发现死者趴在地上,脖子卡在     

49例一氧化碳中毒死亡特征分析

对CO中毒死亡案件的判定,主要是依据血碳氧血红蛋白（COHb）浓度。但在实际案例中,会遇到血COHb浓度低于致死浓度的情况,从而对CO中毒死亡的判定带来了一定困难。本文通过分析49例CO中毒死亡案件的法医学特点,     

一氧化碳中毒合并颅内血肿死亡1例

1案例资料赵某(女,34岁)与其子阮某(男,9岁),2002年1月13日因患感冒在个体诊所就诊并取感冒药和消炎药,当晚服药物后赵某将煤炉移至二人所住卧室内并关门睡觉,15日凌晨5时赵某从昏睡中清醒后发现其子阮某已死亡。因怕家人责怪,把煤炉移至厨房后于当日下午3时向公安机关报案,谎称其子系药物致死。1.1现场简况现场为二室二厅,室内面积约100m2,门窗完好。厨房内有一个已熄灭的煤炉。赵某母子二人所住卧室面积约18m2,木制房门,推拉式铝合金窗户,密封性好。床上及地面上可见二处呕吐物,提取备检。1.2尸体检验尸长132cm,尸僵强度,尸斑固定,呈樱桃…     

火场中尸体的法医学分析

火场中的尸体是法医病理工作者较常见的案件,在这种案件中,判断是生前烧死还是死后焚尸具有非常重要的意义。本文就相关文献关于火灾死亡案件的尸体内部、外部征象、现场特点、以及以COHb为主的实验室结果加以综述,目的在于阐明这些特征在实际案件中的作用和应用,为法医工作者解决此类案件提供参考。     

高度腐败尸体急性一氧化碳中毒鉴定1例

1案例某年2月10日下午,某街道一出租屋内发现一具男尸,尸体已经高度腐败,经辨认死者系租客吴某,男性,31岁。现场门锁未发现破坏痕迹,室内有两个煤炉．炉旁堆有一些蜂窝煤．其中一个煤炉内煤炭呈未完全燃烧状态。     

一氧化碳中毒后死伤并存2例

1案例案例1 李某（女,31岁）及其女儿（5岁）被人发现昏倒在家中。即送往医院抢救。损伤检验：李某呈昏迷状态,生命体征平稳,右侧顶颞部见3cm-2cm头皮红斑,右侧肘部见2cm-2cm皮肤红斑、水泡,髋部右侧见3cm-2cm皮肤红斑,右侧外踝部见2cm×2cm皮肤红斑、水泡。其女儿已经死亡.     

氧气瓶内充入高纯度一氧化碳致人死亡1例

正1案例1.1简要案情张某,男,某晚19:00许,被其继子李某发现俯卧在床上,呼之不应,已死去多时。现场为一小区楼房,面积约70m2,封闭性较好,北面阳台有一土暖炉。卧室床枕头上有呕吐痕迹,床内侧有一蓝色氧气瓶和一带有面罩的复苏球囊。据调查张某夫妻二人均为再婚,关系不和,1年前张某曾因感情问题写过遗书。张     

一氧化碳（CO）中毒检测方法

作者查阅近20年国内外相关文献的基础上,对一氧化碳(CO)中毒的检验方法进行了全面的阐述,同时对每种方法的优缺点和适用条件作了比较,并对适用于我国国情的顶空气质联用法进行了改良.     

Concentration of carbon monoxide (CO) in postmortem human tissues: effect of environmental CO exposure

We studied how carbon monoxide (CO) is distributed within the human body through quantitation of CO concentrations in postmortem tissue samples from fatalities including possible CO exposure. Stored, frozen tissues were diced, sonicated in water, and 0.01-8.0 mg wet weight (ww) tissues were incubated with sulfosalicylic acid in CO-purged, septum-sealed vials. CO released into the headspace was quantitated by reduction gas chromatography. Mean tissue CO concentrations (pmol/mg ww) from subjects diagnosed to have no known CO exposure (control, N=14), died from fire (N=13), and CO asphyxiation (N=7), respectively, were: adipose (2;13;9), brain (3;13;65), muscle (15;97;297), heart (30;99;371), kidney (22;432;709, lung (54;690;2638), spleen (73;1366;3548), and blood (162;2238;5070). Carboxyhemoglobin concentrations were 1.4%, 25.2%, and 69.1% of total hemoglobin, respectively. We conclude that measurements of CO concentration in a variety of tissues can be used as markers for the degree of exogenous CO exposure and the identification of possible causes of death.     

甲醛对一氧化碳中毒血检验干扰的研究

目的探讨甲醛对一氧化碳中毒血的检测是否产生干扰,提高一氧化碳中毒鉴定的可靠性。方法采用常用的血中一氧化碳或碳氧血红蛋白饱和度的检测方法对未加甲醛和加甲醛的血样分别进行实验研究。结果甲醛对加热法、氢氧化钠法、氯化钯法、分光光度法等检测方法均可产生不同程度的干扰。结论经福尔马林灌注或固定的检材不宜用于一氧化碳中毒血检测,否则可能导致错误的鉴定结论。     

一氧化碳中毒血分光光度定量分析法比较

目的比较7种一氧化碳中毒血样分光光度含量测定方法的特点及适用性。方法用空白血添加一氧化碳配制不同浓度的样品,采用双波长法、还原法（3种）、切线法和导数光谱法（2种）进行检测,对各种方法线性范围、重现性和操作中注意事项等内容进行考察,并用实际案件检材验证和比较。结果还原法一在30%~70%、还原法三在20%~100%,其他方法在20%~70%范围内,线性关系良好;样本浓度超过或低于50%,采用切线法有一定误差;导数法及还原法三因需要制备CO饱和样本,操作略微繁琐,但导数光谱法计算结果准确性好。结论几种方法均可用于一氧化碳中毒血的检测,实验结果可为方法的实际应用提供借鉴和帮助。     

Accidental boric acid poisoning following the ingestion of household pesticide

Borate-containing compounds were formerly used as topical antiseptics and were components of many medicinal preparations including skin powders and ointments used for the treatment of burns and diaper rash. These compounds were also used as irrigants for body cavities, including the pleural, vaginal, and rectal cavities. These applications were subsequently discontinued by the medical community when the toxicity and potential lethality of borates were recognized. Although documented cases of borate poisoning are now rare, the chemical is still an active component commonly used in high concentrations in household disinfectants/cleaners, pesticides, and wood preservatives. While the majority of documented borate-related deaths have occurred in infants, the toddler population is currently at risk due to possible exposure to these household products. We present the case of an 18-month-old child who died following the accidental ingestion of a boric acid-containing, commercially available roach pesticide product.     

Diesel fumes do kill: a case of fatal carbon monoxide poisoning directly attributed to diesel fuel exhaust with a 10-year retrospective case and literature review*

While it is known that diesel fuel combustion engines produce much lower concentrations of carbon monoxide (CO) than gasoline engines, these emissions could certainly generate lethal ambient concentrations given a sufficient amount of time in an enclosed space and under suitable environmental conditions. The authors report a case of CO poisoning which was initially referred for autopsy as a presumed natural death of a truck driver found in the secure cab of a running diesel tractor trailer truck. Completion of the preliminary investigation ascribed death to complications of ischemic heart disease (IHD), pending toxicological analysis that included quantification of CO. When the toxicology results showed lethal blood COHbg, the cause of death was re-certified as CO intoxication secondary to inhalation of (diesel) vehicular exhaust fumes. Because of the unique source of fatal CO intoxication in this case, the contributory IHD and the possible contaminants in the putrefied blood, a 10-year retrospective review was conducted on all nonfire related CO deaths autopsied (n = 94) at the Office of the Chief Medical Examiner in Louisville, KY from 1994 to 2003. For validation of the COHbg detection method used by the Kentucky Office of Forensic Toxicology (KYOFT), blood samples from these cases along with controls were submitted to three laboratories using various analytical methods yielding no statistically significant differences. Lastly, an extensive literature review produced no scientifically reported cases of fatal CO poisoning attributed to diesel fuel exhaust.     

Trends in suicide by carbon monoxide inhalation in King County, Washington: 1996-2009

Carbon monoxide (CO) inhalation is one of the leading methods of suicide in the United States. A sharp increase in suicide by inhaling the CO produced from burning charcoal has been reported in parts of Asia; however, the incidence of this method has not been determined in a U.S. population. Thus, we determined trends of CO suicide in the ethnically diverse population of King County, Washington, U.S.A. During the period 1996-2009, we identified 158 cases of suicide by CO poisoning, with 125 because of automotive exhaust, 26 because of charcoal burning, and seven from other CO sources. While historical U.S. data indicate >99% of CO suicides in the United States occurring by automobile exhaust inhalation, in the most recent years analyzed, c. 40% of CO-related suicides in King County, Washington, were because of charcoal burning, indicating a possible shift in suicide trends that warrants further scrutiny in additional populations.     

A charred body inside a burning car with a garden hose connected to the exhaust pipe: Post-mortem self-immolation,a complex or a complicated suicide after the ingestion of alcohol? The importance of an interdisciplinary approach

The analysis of charred bodies represents a serious challenge for forensic pathologists, and an interdisciplinary approach is often the only way to determine the cause and manner of death. We present an unusual case in which the charred body of a 61-year-old man was found inside his burning vehicle. In order to determine cause and manner of death, an interdisciplinary team was employed, with experts in forensic pathology, forensic radiology, toxicology and fire investigations. Post-mortem computed tomography, autopsy and toxicology ruled out the presence of trauma injury and detected signs of vital exposure to fire and blood alcohol levels. On the other hand, according to fire investigations, the fire started inside the car and partially burned fragments of a garden hose were found along the right side of the car. A suicide could therefore be hypothesized, with the man having attempted to poison himself with the car's exhaust fumes and having set the car on fire. The death was consistent with a complicated suicide in which the victim, in a state of reduced capability, accidentally set his car on fire and was unable to escape. The hypothesis of a complex suicide, with the car having been set deliberately on fire, could not, however, be ruled out.     

Suicidal asphyxiation by inhalation of automobile emission without carbon monoxide poisoning

Reported herein is the suicidal asphyxiation of a young man due to exhaustion of oxygen in the interior of a sealed automobile into which the exhaust emissions were diverted. His blood carboxyhemaglobin concentration was less than 5% saturation. The car was equipped with a catalytic converter and when tested, the exhaust carbon monoxide concentration was 0.01%.