Wirthwein D P, Pless J E
Division of Forensic Pathology, Indiana University, Indianapolis 46202-5120, USA.
Am J Forensic Med Pathol. 1996 Jun;17(2):117-23. doi: 10.1097/00000433-199606000-00007.
The determination of death by trauma versus fire can be of major consideration, especially in civil product liability litigation. Blood carboxyhemoglobin levels can be instrumental in that differentiation. Twenty-eight fatalities involving fire in automobiles were reviewed. All subjects displayed some degree of body burn, and in 25 severe charring and/or incineration was present at autopsy. In only one case was there a history of explosion or flash fire. Carboxyhemoglobin levels varied from 92% to values of < 10%. In seven cases no collision occurred. In six of these subjects COHb values were > or = 47%. In all 16 cases with carboxyhemoglobin levels of < or = 10% a collision occurred. In 12 of 16 of these subjects, blunt force injury sufficient to cause death was discovered. Data presented in this article indicate that a carboxyhemoglobin level of > 30% strongly suggests inhalation of combustion products as the cause of death. In contrast, a level of < 20% should prompt a search for other causes.
确定死因是因创伤还是火灾至关重要，尤其是在民事产品责任诉讼中。血液中碳氧血红蛋白水平有助于做出这种区分。对28起汽车火灾致死案例进行了回顾。所有受试者均有一定程度的身体烧伤，其中25例在尸检时出现严重烧焦和/或焚烧情况。仅1例有爆炸或闪燃病史。碳氧血红蛋白水平从92%到低于10%不等。7例未发生碰撞。其中6例受试者的碳氧血红蛋白值≥47%。在所有碳氧血红蛋白水平≤10%的16例案例中均发生了碰撞。在这16例中的12例中，发现了足以致死的钝器伤。本文所呈现的数据表明，碳氧血红蛋白水平>30%强烈提示吸入燃烧产物是死因。相比之下，水平<20%则应促使寻找其他死因。
