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Titel: Relative blood loss in forensic medicine-do we need a change in doctrine?
VerfasserIn: Potente, Stefan
Ramsthaler, Frank
Kettner, Mattias
Sauer, Patrick
Schmidt, Peter
Sprache: Englisch
Titel: International Journal of Legal Medicine
Bandnummer: 134
Heft: 3
Seiten: 1123–1131
Verlag/Plattform: Springer Nature
Erscheinungsjahr: 2020
Freie Schlagwörter: Exsanguination
Reference values
Blood loss
Forensic
Haemorrhagic shock
Hypovolemic shock
ATLS
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: In forensic medicine, blood loss is encountered frequently, either as a cause of death or as a contributing factor. Here, risk to life and lethality assessment is based on the concept of relative blood loss (absolute loss out of total volume). In emergency medicine, the Advanced Trauma Life Support (ATLS) classification also refers to relative blood loss. We tested the validity of relative blood loss benchmarks with reference to lethality. Depending on the quality of the total blood volume (TBV) estimation formula, relative blood loss rates should be reflected in the case cohort as significantly higher absolute blood loss in heavier individuals since all TBV estimation formulas positively correlate body weight with TBV. Method: 80 autopsy cases with sudden, quantifiable, exclusively internal blood loss were retrospectively analyzed and a total of 8 different formulas for TBV estimation were applied. Results: No statistical correlation between body weight and absolute blood loss was found for any of the tested TBV estimation algorithms. All cases showed a wide spread of both absolute and relative blood loss. Discussion: The principle of relative blood loss is of very limited use in casework. It opens the forensic expert opinion to unnecessary criticism and possible negative legal implications. Conclusion: We challenge the use of relative blood loss benchmarks in textbooks and practical casework and advocate for its elimination from the ATLS’s grading system. If necessary, we recommend the use of BMI-adjusted algorithms for TBV estimation.
DOI der Erstveröffentlichung: 10.1007/s00414-020-02260-w
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-337852
hdl:20.500.11880/31116
http://dx.doi.org/10.22028/D291-33785
ISSN: 1437-1596
0937-9827
Datum des Eintrags: 12-Apr-2021
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Rechtsmedizin
Professur: M - Keiner Professur zugeordnet
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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