Kudo K, Nagata T, Imamura T, Jitsufuchi N, Kashimura S
Department of Forensic Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Nihon Hoigaku Zasshi. 1995 Jun;49(3):169-74.
Brain death was diagnosed by analyzing drug distribution in human tissues. Concentrations of diazepam and phenobarbital in human tissues, administered therapeutically to 3 patients in a critical condition, were determined by gas chromatography with a nitrogen phosphorus detector and gas chromatography-mass spectrometry. In 2 patients administered drugs while the brain was functioning, drug concentrations in the brain were high compared with those in the other tissues. In the other patient given the drugs after vital signs of the brain ceased, the level of drugs in the brain was much lower than seen in other tissues. We propose that a forensic diagnosis of patients who are brain dead can be made by comparing the concentrations of drugs in the brain given at the time of critical condition with concentration of these agents in other tissues. When cerebral function ceased can be roughly estimated by the variable distribution patterns of drugs and time of administration of these drugs.
通过分析人体组织中的药物分布来诊断脑死亡。采用带氮磷检测器的气相色谱法和气相色谱-质谱联用法，测定了3例危重症患者经治疗给药后人体组织中地西泮和苯巴比妥的浓度。在2例大脑仍在运作时给药的患者中，大脑中的药物浓度高于其他组织。在另1例大脑生命体征停止后给药的患者中，大脑中的药物水平远低于其他组织。我们建议，通过比较危重症时给予的药物在大脑中的浓度与这些药物在其他组织中的浓度，对脑死亡患者进行法医诊断。根据药物的可变分布模式和给药时间，可以大致估算出脑功能停止的时间。
