Helium Poisoning: New Procedure for Sampling and Analysis

TY - JOUR

T1 - Helium Poisoning: New Procedure for Sampling and Analysis

AU - Varlet, Vincent

AU - Iwersen-Bergmann, S

AU - Alexandre, M

AU - Cordes, O

AU - Wunder, C

AU - Holz, F

AU - Andresen-Streichert, H

AU - Bevalot, F

AU - Dumestre-Toulet, V

AU - Malbranque, S

AU - Fracasso, T

AU - Grabherr, S

PY - 2019/11

Y1 - 2019/11

N2 - An increasing number of suicidal asphyxiation with a plastic bag with inert gases, and in particular helium (He), have been reported from numerous countries over the last decade. These cases are differently managed and lead to different and variable interpretations. Based on the 12 last cases analysed in the laboratory and on the review of the most recent literature about this topic, updated autopsy guidelines for sampling have been proposed regarding to the samples choice and analytical challenges required by the gaseous state of this substance. Biological samples from airways (lungs lobe) followed by brain and cardiac blood are the best matrices to take during the autopsy to diagnose He exposure. Gaseous samples from trachea, pulmonary bronchi, gastric and cardiac areas are also recommended as alternative samples. The anatomical site of sampling must be carefully detailed, and to this end, forensic imaging constitutes a beneficial tool. Even if He detection is sufficient to conclude to He exposure, He concentrations in samples may be related to He exposure conditions (duration, breathing rate, etc.). A quantification in biological samples could be helpful to document more precisely the case. He concentrations in gaseous samples are reported up to 6.0 μmol/mL (tracheal gas), 2.4 μmol/mL (pulmonary gas), 0.64 μmol/mL (cardiac gas) and 12 μmol/mL (gastric gas). He concentrations in solid/liquid samples are reported up to 28 μmol/g (lungs) and 0.03 μmol/g (cardiac blood). The other matrices usually sampled during autopsy such as urine, peripheral blood, liver, fat matter and kidney appear as not relevant.

AB - An increasing number of suicidal asphyxiation with a plastic bag with inert gases, and in particular helium (He), have been reported from numerous countries over the last decade. These cases are differently managed and lead to different and variable interpretations. Based on the 12 last cases analysed in the laboratory and on the review of the most recent literature about this topic, updated autopsy guidelines for sampling have been proposed regarding to the samples choice and analytical challenges required by the gaseous state of this substance. Biological samples from airways (lungs lobe) followed by brain and cardiac blood are the best matrices to take during the autopsy to diagnose He exposure. Gaseous samples from trachea, pulmonary bronchi, gastric and cardiac areas are also recommended as alternative samples. The anatomical site of sampling must be carefully detailed, and to this end, forensic imaging constitutes a beneficial tool. Even if He detection is sufficient to conclude to He exposure, He concentrations in samples may be related to He exposure conditions (duration, breathing rate, etc.). A quantification in biological samples could be helpful to document more precisely the case. He concentrations in gaseous samples are reported up to 6.0 μmol/mL (tracheal gas), 2.4 μmol/mL (pulmonary gas), 0.64 μmol/mL (cardiac gas) and 12 μmol/mL (gastric gas). He concentrations in solid/liquid samples are reported up to 28 μmol/g (lungs) and 0.03 μmol/g (cardiac blood). The other matrices usually sampled during autopsy such as urine, peripheral blood, liver, fat matter and kidney appear as not relevant.

KW - Asphyxia

KW - Brain Chemistry

KW - Bronchi/chemistry

KW - Forensic Toxicology/methods

KW - Gas Chromatography-Mass Spectrometry

KW - Heart Ventricles/chemistry

KW - Helium/analysis

KW - Humans

KW - Inhalant Abuse

KW - Lung/chemistry

KW - Poisoning/diagnosis

KW - Specimen Handling

KW - Stomach/chemistry

KW - Suicide

KW - Trachea/chemistry

U2 - 10.1007/s00414-019-02014-3

DO - 10.1007/s00414-019-02014-3

M3 - SCORING: Journal article

C2 - 30734118

VL - 133

SP - 1809

EP - 1818

JO - INT J LEGAL MED

JF - INT J LEGAL MED

SN - 0937-9827

IS - 6

ER -