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Erschienen in: International Journal of Legal Medicine 4/2015

01.07.2015 | Original Article

Postmortem angiography using femoral cannulation and postmortem microbiology

verfasst von: Cristian Palmiere, Coraline Egger, Silke Grabherr, Katia Jaton-Ogay, Gilbert Greub

Erschienen in: International Journal of Legal Medicine | Ausgabe 4/2015

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Abstract

Despite the undeniable advantages of postmortem angiography, numerous questions have arisen concerning the influence that the injected contrast media may exercise on biological fluids and tissues collected for toxicological and biochemical investigations. Moreover, cardiac blood for microbiological investigations cannot be obtained post-angiography. In this study, we examined whether the peripheral blood collected prior to postmortem angiography, using percutaneous access to femoral vessels after skin surface disinfection, could be suitable for microbiological investigations when postmortem angiography with femoral vessel cannulation is also performed. A total of 66 cases were included in the study and were divided into two subgroups (angiography and bacteriology group, 33 cases and control group, 33 cases). Autopsies, histology, toxicology, bacteriology, and biochemical investigations (procalcitonin, C-reactive protein, interleukin-6, and soluble triggering receptors expressed on myeloid cells type 1) were performed in all cases. No statistically significant differences between the two groups were noted, and identified category distribution (death unrelated to infection, true infection, false positive, and undetermined) was rather similar in both studied populations. These preliminary results suggest that postmortem angiography using a femoral approach does not constitute an impediment to the collection of peripheral blood for microbiology and vice versa. Moreover, the use of femoral blood for microbiology does not lead to an increased risk of doubtful results.
Literatur
1.
Zurück zum Zitat Palmiere C, Binaghi S, Doenz F, Bize P, Chevallier C, Mangin P, Grabherr S (2012) Detection of hemorrhage source: the diagnostic value of post-mortem CT-angiography. Forensic Sci Int 222:33–39PubMedCrossRef Palmiere C, Binaghi S, Doenz F, Bize P, Chevallier C, Mangin P, Grabherr S (2012) Detection of hemorrhage source: the diagnostic value of post-mortem CT-angiography. Forensic Sci Int 222:33–39PubMedCrossRef
2.
Zurück zum Zitat Grabherr S, Widmer C, Iglesias K, Sporkert F, Augsburger M, Mangin P, Palmiere C (2012) Postmortem biochemistry performed on vitreous humor after postmortem CT-angiography. Leg Med (Tokyo) 14:297–303CrossRef Grabherr S, Widmer C, Iglesias K, Sporkert F, Augsburger M, Mangin P, Palmiere C (2012) Postmortem biochemistry performed on vitreous humor after postmortem CT-angiography. Leg Med (Tokyo) 14:297–303CrossRef
3.
Zurück zum Zitat Rutty GN, Smith P, Visser T, Barber J, Amorosa J, Morgan B (2013) The effect on toxicology, biochemistry and immunology investigations by the use of targeted post-mortem computed tomography angiography. Forensic Sci Int 225:42–47PubMedCrossRef Rutty GN, Smith P, Visser T, Barber J, Amorosa J, Morgan B (2013) The effect on toxicology, biochemistry and immunology investigations by the use of targeted post-mortem computed tomography angiography. Forensic Sci Int 225:42–47PubMedCrossRef
5.
Zurück zum Zitat Weber MA, Hartley JC, Brooke I, Lock PE, Klein NJ, Malone M, Sebire NJ (2010) Post-mortem interval and bacteriological culture yield in sudden unexpected death in infancy (SUDI). Forensic Sci Int 198:121–125PubMedCrossRef Weber MA, Hartley JC, Brooke I, Lock PE, Klein NJ, Malone M, Sebire NJ (2010) Post-mortem interval and bacteriological culture yield in sudden unexpected death in infancy (SUDI). Forensic Sci Int 198:121–125PubMedCrossRef
6.
Zurück zum Zitat Weber MA, Klein NJ, Hartley JC, Lock PE, Malone M, Sebire NJ (2008) Infection and sudden unexpected death in infancy: a systematic retrospective case review. Lancet 371:1848–1853PubMedCrossRef Weber MA, Klein NJ, Hartley JC, Lock PE, Malone M, Sebire NJ (2008) Infection and sudden unexpected death in infancy: a systematic retrospective case review. Lancet 371:1848–1853PubMedCrossRef
7.
Zurück zum Zitat Morris JA, Harrison LM, Partridge SM (2007) Practical and theoretical aspects of postmortem bacteriology. Curr Diagn Pathol 13:65–74CrossRef Morris JA, Harrison LM, Partridge SM (2007) Practical and theoretical aspects of postmortem bacteriology. Curr Diagn Pathol 13:65–74CrossRef
8.
Zurück zum Zitat Tuomisto S, Karhunen PJ, Vuento R, Aittoniemi J, Pessi T (2013) Evaluation of postmortem bacterial migration using culturing and real-time quantitative PCR. J Forensic Sci 58:910–916PubMedCrossRef Tuomisto S, Karhunen PJ, Vuento R, Aittoniemi J, Pessi T (2013) Evaluation of postmortem bacterial migration using culturing and real-time quantitative PCR. J Forensic Sci 58:910–916PubMedCrossRef
9.
Zurück zum Zitat Krous HF, Beckwith JB, Byard RW, Rognum TO, Bajanowski T, Corey T, Cutz E, Hanzlick R, Keens TG, Mitchell EA (2004) Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach. Pediatrics 114:234–238PubMedCrossRef Krous HF, Beckwith JB, Byard RW, Rognum TO, Bajanowski T, Corey T, Cutz E, Hanzlick R, Keens TG, Mitchell EA (2004) Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach. Pediatrics 114:234–238PubMedCrossRef
10.
Zurück zum Zitat Bajanowski T, Vege A, Byard RW, Krous HF, Arnestad M, Bachs L, Banner J, Blair PS, Borthne A, Dettmeyer R, Fleming P, Gaustad P, Gregersen M, Grøgaard J, Holter E, Isaksen CV, Jorgensen JV, de Lange C, Madea B, Moore I, Morland J, Opdal SH, Råsten-Almqvist P, Schlaud M, Sidebotham P, Skullerud K, Stoltenburg-Didinger G, Stray-Pedersen A, Sveum L, Rognum TO (2007) Sudden infant death syndrome (SIDS)–standardised investigations and classification: recommendations. Forensic Sci Int 165:129–143PubMedCrossRef Bajanowski T, Vege A, Byard RW, Krous HF, Arnestad M, Bachs L, Banner J, Blair PS, Borthne A, Dettmeyer R, Fleming P, Gaustad P, Gregersen M, Grøgaard J, Holter E, Isaksen CV, Jorgensen JV, de Lange C, Madea B, Moore I, Morland J, Opdal SH, Råsten-Almqvist P, Schlaud M, Sidebotham P, Skullerud K, Stoltenburg-Didinger G, Stray-Pedersen A, Sveum L, Rognum TO (2007) Sudden infant death syndrome (SIDS)–standardised investigations and classification: recommendations. Forensic Sci Int 165:129–143PubMedCrossRef
11.
Zurück zum Zitat Lobmaier IV, Vege A, Gaustad P, Rognum TO (2009) Bacteriological investigation—significance of time lapse after death. Eur J Clin Microbiol Infect Dis 28:1191–1198PubMedCrossRef Lobmaier IV, Vege A, Gaustad P, Rognum TO (2009) Bacteriological investigation—significance of time lapse after death. Eur J Clin Microbiol Infect Dis 28:1191–1198PubMedCrossRef
12.
Zurück zum Zitat Zanen-Lim OG, Zanen HC (1980) Postmortem bacteriology of the lung by printculture of frozen tissue. A technique for in situ culture of microorganisms in whole frozen organs. J Clin Pathol 33:474–480PubMedCentralPubMedCrossRef Zanen-Lim OG, Zanen HC (1980) Postmortem bacteriology of the lung by printculture of frozen tissue. A technique for in situ culture of microorganisms in whole frozen organs. J Clin Pathol 33:474–480PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Tsokos M, Püschel K (2001) Postmortem bacteriology in forensic pathology: diagnostic value and interpretation. Leg Med (Tokyo) 3:15–22CrossRef Tsokos M, Püschel K (2001) Postmortem bacteriology in forensic pathology: diagnostic value and interpretation. Leg Med (Tokyo) 3:15–22CrossRef
14.
Zurück zum Zitat Grabherr S, Doenz F, Steger B, Dirnhofer R, Dominguez A, Sollberger B, Gygax E, Rizzo E, Chevallier C, Meuli R, Mangin P (2011) Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Legal Med 125:791–802PubMedCrossRef Grabherr S, Doenz F, Steger B, Dirnhofer R, Dominguez A, Sollberger B, Gygax E, Rizzo E, Chevallier C, Meuli R, Mangin P (2011) Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Legal Med 125:791–802PubMedCrossRef
15.
Zurück zum Zitat Palmiere C, Bardy D, Mangin P, Augsburger M (2013) Value of sTREM-1, procalcitonin and CRP as laboratory parameters for postmortem diagnosis of sepsis. J Infect 67:545–555PubMedCrossRef Palmiere C, Bardy D, Mangin P, Augsburger M (2013) Value of sTREM-1, procalcitonin and CRP as laboratory parameters for postmortem diagnosis of sepsis. J Infect 67:545–555PubMedCrossRef
16.
Zurück zum Zitat Schrag B, Roux-Lombard P, Schneiter D, Vaucher P, Mangin P, Palmiere C (2012) Evaluation of C-reactive protein, procalcitonin, tumor necrosis factor alpha, interleukin-6, and interleukin-8 as diagnostic parameters in sepsis-related fatalities. Int J Legal Med 126:505–512PubMedCrossRef Schrag B, Roux-Lombard P, Schneiter D, Vaucher P, Mangin P, Palmiere C (2012) Evaluation of C-reactive protein, procalcitonin, tumor necrosis factor alpha, interleukin-6, and interleukin-8 as diagnostic parameters in sepsis-related fatalities. Int J Legal Med 126:505–512PubMedCrossRef
17.
Zurück zum Zitat Llewelyn MJ, Berger M, Gregory M, Ramaiah R, Taylor AL, Curdt I, Lajaunias F, Graf R, Blincko SJ, Drage S, Cohen J (2013) Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care. Crit Care 17:R60PubMedCentralPubMedCrossRef Llewelyn MJ, Berger M, Gregory M, Ramaiah R, Taylor AL, Curdt I, Lajaunias F, Graf R, Blincko SJ, Drage S, Cohen J (2013) Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care. Crit Care 17:R60PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Martinez OV, Malinin TI, Valla PH, Flores A (1985) Postmortem bacteriology of cadaver tissue donors: an evaluation of blood cultures as an index of tissue sterility. Diagn Microbiol Infect Dis 3:193–200PubMedCrossRef Martinez OV, Malinin TI, Valla PH, Flores A (1985) Postmortem bacteriology of cadaver tissue donors: an evaluation of blood cultures as an index of tissue sterility. Diagn Microbiol Infect Dis 3:193–200PubMedCrossRef
20.
Zurück zum Zitat Varettas K (2013) Micro-organisms isolated from cadaveric samples of allograft musculoskeletal tissue. Cell Tissue Bank 14:621–625PubMedCrossRef Varettas K (2013) Micro-organisms isolated from cadaveric samples of allograft musculoskeletal tissue. Cell Tissue Bank 14:621–625PubMedCrossRef
21.
Zurück zum Zitat Bettin D, Harms C, Polster J, Niemeyer T (1998) High incidence of pathogenic microorganisms in bone allografts explanted in the morgue. Acta Orthop Scand 69:311–314PubMedCrossRef Bettin D, Harms C, Polster J, Niemeyer T (1998) High incidence of pathogenic microorganisms in bone allografts explanted in the morgue. Acta Orthop Scand 69:311–314PubMedCrossRef
22.
Zurück zum Zitat Obeng MK, McCauley RL, Barnett JR, Heggers JP, Sheridan K, Schutzler SS (2001) Cadaveric allograft discards as a result of positive skin cultures. Burns 27:267–271PubMedCrossRef Obeng MK, McCauley RL, Barnett JR, Heggers JP, Sheridan K, Schutzler SS (2001) Cadaveric allograft discards as a result of positive skin cultures. Burns 27:267–271PubMedCrossRef
24.
Zurück zum Zitat Søgaard P, Larsen KE, Buhl L, Lou HE, Henriques U (1991) Bacteriological autopsy. I. A methodological study. APMIS 99:541–544PubMedCrossRef Søgaard P, Larsen KE, Buhl L, Lou HE, Henriques U (1991) Bacteriological autopsy. I. A methodological study. APMIS 99:541–544PubMedCrossRef
25.
Zurück zum Zitat Silver H, Sonnenwirth AC (1969) A practical and efficacious method for obtaining significant postmortem blood cultures. Am J Clin Pathol 52:433–437PubMed Silver H, Sonnenwirth AC (1969) A practical and efficacious method for obtaining significant postmortem blood cultures. Am J Clin Pathol 52:433–437PubMed
Metadaten
Titel
Postmortem angiography using femoral cannulation and postmortem microbiology
verfasst von
Cristian Palmiere
Coraline Egger
Silke Grabherr
Katia Jaton-Ogay
Gilbert Greub
Publikationsdatum
01.07.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Legal Medicine / Ausgabe 4/2015
Print ISSN: 0937-9827
Elektronische ISSN: 1437-1596
DOI
https://doi.org/10.1007/s00414-014-1099-5

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