Postmortem biochemical estimations in cases of fatal hypothermia (catecholamines and volatiles)

A hypothermic state represents intense stress accompanied by a massive release of catecholamines. Their estimation can be used to confirm this mechanism of death. We investigated four cases of fatal hypothermia and 12 controls with short and longer agonies on which were performed estimations of adrenaline/noradrenaline and volatile substances (ethanol, methanol, propanol-1, -2, acetone). - In cases of cold death always a predominance of noradrenaline was present (approx. 10-to 32 fold). This corresponds to cases with longer agony. The mean quotients adrenaline/noradrenaline ranged between 0.10 and 0.79. Significant differences were seen especially with cases characterized by short agony in which adrenaline levels were remarkably higher than those of noradrenaline (factor of approx. 4 to 10, quotients varying from 3.8 to 17). Elevated acetone levels were only found in ethanol-free cases while acetone and propanol-2 were both high. In hypothermia with relevant alcoholisation these were within the physiological range what can be due to an anti-lipolytic effect of ethanol. - Therefore, combined estimation of catecholamines and volatile substances in several compartments can have diagnostic value to verify fatal hypothermia