PhD defence L.C.P. (Lennaert) Borra

Postmortem redistribution in humans

Important variables that might be influencing the central blood/peripheral blood ratio

Concentrations of drugs in the blood of a deceased person after death, do not necessarily reflect the concentrations of these drugs in the blood at the time of death. This is (among other factors) caused by redistribution of drugs in the body after death. 

Prior to death, drugs tend to accumulate in organs, such as lungs and liver, resulting in drug concentration in these organs that are potentially several times higher than in blood. After death, these drugs can redistribute in the body.

A marker for this redistribution is the ratio between drug concentrations in the femoral blood and the cardiac blood. Due to the proximity of the cardiac blood to organs, concentrations potentially change earlier and to a larger extent compared to the femoral blood.

In this dissertation the potential influence of several factors on the ratio between drug concentrations in the femoral blood and the cardiac blood is investigated for several drugs. Information collected during death investigations conducted by the Netherlands Forensic Institute between 2010 and 2020 was used.

Examples of observed differences are differences between deceased persons with low and high drug concentrations in blood, between deceased persons with and without trauma and between deceased persons with a normal and high BMI. Taking these factors into account when conducting a death investigation might result in a better estimation of concentrations and effects of drugs at the time of death.

Supervisors:prof. dr. D.J. (Daan) Touw, prof. dr. P.H. (Philip) Elsinga
Co-supervisors:dr. H.H. (Hendrikus) Boersma, dr. I.J. Bosman