Comparison of Alcohol Levels in Right Heart Blood, Left Heart Blood and Femoral Blood in 30 forensic Autopsy Cases

Alcohol is the most commonly used and abused drug in the world. Ethanol is also the most commonly detected drug in deaths from all cases but the highest incidence was reported to be in trauma cases. The detection and interpretation of postmortem blood alcohol concentrations and their relationship to impairment or contribution to the cause of death is a significant issue in forensic toxicology. Alcohol levels of body fluid can be reliably determined in blood, vitreous humor, urine, breath, cerebrospinal fluid, saliva and bile. The "gold standard" in analysis of postmortem alcohol levels in forensic settings is whole blood (femoral or subclavian veins) by headspace chromatography. In this study we compared the alcohol concentrations in right heart blood, left heart blood and peripheral (femoral) blood of 30 adult forensic autopsy cases. Blood levels of ethanol and methanol of three different sampling sites were analyzed by HSGC and the results were statistically evaluated. There was no statistically significant relationship both between the age and post-mortem interval with the alcohol levels in three sampling sites. When the differences between the alcohol levels of these different three sampling sites were analyzed, while there was no statistically significant difference between the levels of left heart blood and femoral blood, the levels both in left heart and femoral blood were found to be significantly higher than that of the right heart (P values 0.05 and 0.013). In cases showing obvious gastric regurgitation, the difference between the left heart blood and right heart blood was prominent. Our study indicates that left heart blood alcohol level is higher than that of the right heart and the difference is particularly marked in cases showing the findings of gastric regurgitation and thus showing the importance of choice of the right heart blood in cases where the sampling of peripheral blood is not possible.