Possible postmortem serum markers for differentiation between fresh-, saltwater drowning and acute cardiac death: A preliminary investigation

Bao Li Zhu, Kaori Ishida, Mari Taniguchi, Li Quan, Shigeki Oritani, Kohei Tsuda, Yasunobu Kamikodai, Masaki Q. Fujita, Hitoshi Maeda

Research output: Contribution to journalArticle

46 Citations (Scopus)


The aim of the present study was to investigate the differences in postmortem blood biochemistry between fresh-, saltwater drowning and acute myocardial infarction/ischemia (AMI) (n = 11, n = 15 and n = 23, respectively; postmortem interval <48 h). Left and right cardiac blood samples were examined for the serum markers: sodium (Na), chloride (Cl), magnesium (Mg), blood urea nitrogen (BUN), creatinine (Cr), pulmonary surfactant-associated protein A (SP-A) and cardiac troponin T (cTn-T). The most efficient markers were the left-right cardiac BUN ratio for determination of drowning (hemodilution) and the left heart blood Mg level for differentiation between fresh- and saltwater aspiration. A characteristics feature of saltwater drowning was a low left-right BUN ratio and a marked elevation in the serum Cl, Mg and Ca levels of the left heart blood. Serum cTn-T level was usually low in drowning, showing a difference from most cases of AMI. Freshwater drowning showed a significant elevation of serum SP-A, although there was considerable overlapping with saltwater drowning and AMI. These findings suggested the usefulness of serum markers in the investigation of death from drownings.

Original languageEnglish
Pages (from-to)S298-S301
JournalLegal Medicine
Issue numberSUPPL. 1
Publication statusPublished - 2003 Jan 1
Externally publishedYes



  • Blood biochemistry
  • Blood urea nitrogen
  • Cardiac troponin T
  • Creatinine
  • Drowning
  • Electrolyte
  • Forensic pathology
  • Mineral
  • Pulmonary surfactant-associated protein A

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Issues, ethics and legal aspects

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