The reliability of cardiac haemodilution as a diagnostic test of drowning

Drowning: Still a difficult autopsy diagnosis

“…Dilution of ureum or total proteins can sometimes be demonstrated [49,50]. Haemodilution methods are mostly abandoned due to lack of specificity and sensitivity caused by post-mortem biochemical autolytic and putrefactive deluge [13]. Furthermore, the interpretation can be influenced by cardiac resuscitation, which lowers the values [13].…”

“…As the autopsy is usually only performed 24 h post mortem and referring to the fact that bodies retrieved out of the water usual show an earlier putrefaction, these dilution experiments are hardly performed in current forensic practice. In addition, cardiopulmonary reanimation interferes with haemodilution tests [13]. Some researchers consider these techniques as obsolete [14].…”

Postmortem imaging of blood and its characteristics using MSCT and MRI

“…Later, macromolecules in serum or intracellular ones, such as hemoglobin that are set free by the onset of hemolysis, also diffuse through the venous wall into the interstitium and intensify fixed livores [25]. The degree of hemolysis depends on the specific circumstances linked to the cause of death, which influence cell membrane stability by changing electrolyte concentrations and osmotic pressure gradients within the serum, e.g., in drowning [7,14,19]. Platelets and serum proteins are functionally intact for a variable time shortly after death [31].…”

Diagnostic of Drowning in Forensic Medicine

“…These changes induce haemodilution, hypervolemia, hypnonatremia, hyperkalemia and haemolysis (Jeanmonod et al, 1992). As the sea water is very hypertonic relative to the blood, the water movement goes from blood into the alveoli and the electrolytes (sodium, chloride, magnesium) from the alveoli into the blood.…”