Differences Between Central and Peripheral Postmortem Tryptase Levels
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Differences Between Central and Peripheral Postmortem Tryptase Levels. / Garland, Jack; Ondruschka, Benjamin; Da Broi, Ugo; Palmiere, Cristian; Glenn, Charley; Morrow, Paul; Kesha, Kilak; Stables, Simon; Tse, Rexson.
in: AM J FOREN MED PATH, Jahrgang 42, Nr. 2, 01.06.2021, S. 125-129.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Differences Between Central and Peripheral Postmortem Tryptase Levels
AU - Garland, Jack
AU - Ondruschka, Benjamin
AU - Da Broi, Ugo
AU - Palmiere, Cristian
AU - Glenn, Charley
AU - Morrow, Paul
AU - Kesha, Kilak
AU - Stables, Simon
AU - Tse, Rexson
PY - 2021/6/1
Y1 - 2021/6/1
N2 - ABSTRACT: Postmortem tryptase is a commonly used biochemical test to aid in the diagnosis of fatal anaphylaxis, which is currently recommended to be sampled from peripheral (femoral) veins because of a research showing comparatively elevated levels from central blood sources. Previous studies have used nonstandardized or nondocumented sampling methods; however, more recent research demonstrates that tryptase levels may vary depending on the sampling method. This study used the recommended sampling method of aspirating the femoral vein after clamping and compared in a pairwise comparison with aspiration of central venous and arterial blood sources (inferior vena cava and aorta) in 2 groups of 25 nonanaphylactic deaths. We found no statistically significant differences in postmortem tryptase between central and femoral vein blood; however, sporadic outliers in central blood (particularly aortic blood reaching levels above documented cutoffs for fatal anaphylaxis) were observed. Our findings provide evidence for the existing recommendations that femoral vein blood remains the preferred sample for postmortem tryptase over central blood.
AB - ABSTRACT: Postmortem tryptase is a commonly used biochemical test to aid in the diagnosis of fatal anaphylaxis, which is currently recommended to be sampled from peripheral (femoral) veins because of a research showing comparatively elevated levels from central blood sources. Previous studies have used nonstandardized or nondocumented sampling methods; however, more recent research demonstrates that tryptase levels may vary depending on the sampling method. This study used the recommended sampling method of aspirating the femoral vein after clamping and compared in a pairwise comparison with aspiration of central venous and arterial blood sources (inferior vena cava and aorta) in 2 groups of 25 nonanaphylactic deaths. We found no statistically significant differences in postmortem tryptase between central and femoral vein blood; however, sporadic outliers in central blood (particularly aortic blood reaching levels above documented cutoffs for fatal anaphylaxis) were observed. Our findings provide evidence for the existing recommendations that femoral vein blood remains the preferred sample for postmortem tryptase over central blood.
U2 - 10.1097/PAF.0000000000000623
DO - 10.1097/PAF.0000000000000623
M3 - SCORING: Journal article
C2 - 33031126
VL - 42
SP - 125
EP - 129
JO - AM J FOREN MED PATH
JF - AM J FOREN MED PATH
SN - 0195-7910
IS - 2
ER -