Comments on letter of Sadler and Pounder

✍ Scribed by Jorma Hirvonen; Pirkko Huttunen

• Publisher: Elsevier Science
• Year: 1995
• Tongue: English
• Weight: 51 KB
• Volume: 76
• Category: Article
• ISSN: 0379-0738
• DOI: 10.1016/0379-0738(95)01815-8

✦ Synopsis

The authors point out some pitfalls concerning the use of the urinary catecholamine concentrations as a test for antemortem hypothermia.

Use of creatinine concentration when measuring the catechols as reference is a feasible approach, which we have also considered, but not yet systematically tested in our laboratory. Determination of creatinine gives an idea of the degree of dilution of the urine.

Catechol index (A:NA) in urine is a ratio which we have found to be clearly elevated in hypothermia experiments in guinea-pigs, but not so in rats. It seems to be low in humans because NA is the hormone which is abdundantly released in hypothermia. The role of A is more uncertain. NA values have been high in human hypothermia cases, but A rises less regularly.

We, however, think that clearly elevated NA and A concentrations in cadaver urine signal an antemortem stress having lasted a few hours, although we agree that the interpretation of the results is uncertain and must be done wisely and with caution.

According to our experience, urine is the only fluid from which postmortem measurements of catechols have some value. In blood, the values tend to increase postmortem due to diffusion from nerve endings and adrenals in a couple of days.