From the Division of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
Am J Forensic Med Pathol. 2022 Dec 1;43(4):369-371. doi: 10.1097/PAF.0000000000000768. Epub 2022 May 28.
Deaths from gaseous substances can occur from exposure to toxic gases or from accumulation of nontoxic gases that displace oxygen. We present a 38-year-old man with no known medical history, who was found deceased in a small bathroom with blankets and towels shoved under the door from the inside.At autopsy, the decedent was found to be in a moderate state of decomposition. There was mild pulmonary congestion, with no other significant findings. Standard postmortem toxicology on femoral blood was noncontributory.A search of the decedent's cell phone revealed statements and internet searches regarding carbon dioxide (CO 2 ) and asphyxia using dry ice. A journal entry also outlined a suicide plan using large amounts of dry ice, which was enacted by placing a laundry basket of dry ice into a bathtub containing water. Based on the investigation, the cause of death was determined to be asphyxia from displacement of oxygen with CO 2 .Dry ice sublimates into gaseous CO 2 , which quickly accumulates, with concentrations of 10% or more, rapidly becoming life-threatening. There are no pathognomonic autopsy findings seen in CO 2 -related asphyxia. In these circumstances, scene investigation is the most important factor in determining cause of death.
气体物质导致的死亡可能是由于暴露于有毒气体或由于无毒气体积聚而取代氧气。我们介绍了一位 38 岁的男性，他没有已知的病史，被发现死在一个小浴室里，里面的毯子和毛巾从里面塞住了门。尸检时，死者处于中度腐烂状态。有轻度肺充血，但没有其他明显的发现。股动脉的标准死后毒理学检查没有提供任何信息。对死者手机的搜索显示了有关二氧化碳（CO 2 ）和使用干冰窒息的陈述和互联网搜索。一份日记条目还概述了使用大量干冰的自杀计划，通过将一篮子干冰放入盛有水的浴缸中来实施该计划。根据调查，死因被确定为 CO 2 取代氧气导致窒息。干冰升华成气态 CO 2 ，迅速积聚，浓度达到 10%或更高，很快就会危及生命。在与 CO 2 相关的窒息中没有看到特定的尸检发现。在这些情况下，现场调查是确定死因的最重要因素。
