Cases reported "Asphyxia"

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1/4. Analytical investigations in a death case by suffocation in an argon atmosphere.

    A 31-year-old engineer was found dead in a reaction vessel (diameter 0.8 m, height 1.8 m) of a bulb factory some minutes after he had entered it for repair work. Resuscitation attempts with artificial respiration were unsuccessful. Despite autopsy and usual toxicological analyses, no cause of death could be found. Since in the normal production process, argon was used as a protecting gas, the possibility of suffocation in an argon atmosphere was investigated. This was rendered more difficult because of the natural content of 0.93 vol.% argon in air and since the excessive argon could have been removed by the resuscitation attempts. Gas samples from larynx, esophagus, bronchi, and stomach, separated blood samples from both ventricles of the heart and from the vena iliaca externa as well as tissue samples from lung and liver were collected during autopsy into headspace vials in such a way that the loss of gas and a dilution by surrounding air was avoided as far as possible. The samples were analyzed by headspace GC-MS. The abundance of Ar (m/z = 40) was used for quantification with N2(2 ) (m/z = 14) as internal standard. The following argon concentrations were measured (mean values, case under investigation/comparison cases): gas from larynx 1.79/0.96 vol.%, stomach gas 1.58/0.89 vol.%, heart blood (left ventricle) 7.2/2.7 microg/mL, heart blood (right ventricle) 5.8/2.7 microg/mL, blood from vena iliaca externa 3.6/2.7 microg/mL. A clearly increased concentration was also found in lung tissue, whereas in liver tissue no significant difference in comparison to other cases was measured. From the results, it follows that the deceased inhaled an increased amount of argon a short time before death. The concentrations are consistent with asphyxia and subsequent resuscitation attempts. They cannot be explained by a long-term inhalation of an atmosphere enriched with argon before the incident as it is likely to have occurred in this factory hall.
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2/4. sudden infant death: lingual thyroglossal duct cyst versus environmental factors.

    An 8-month-old female baby was found collapsed in the prone position 30 min after being positioned under soft-bedding. She was taken to the emergency room with cardiopulmonary arrest. Her heartbeat was recovered after resuscitation and continued for 20 h under artificial respiration, at which point the child died. At autopsy, the child showed no significant pathological abnormalities apart from a thyroglossal duct cyst of 2.0 cm diameter, therefore, it seemed that the cyst, which was close to the epiglottis, had caused asphyxia through airways occlusion. However, the child had shown no respiratory problems before death, and the risk of airway occlusion as a result of lingual cysts is more likely in a supine rather than a prone position. A small amount of evidence suggested that the child died as a result of suffocation from being covered by soft-bedding, which could have caused fatal asphyxia; it is also possible that a hypoxic state induced by airway obstruction might have been enhanced by being covered with bedding. It seemed reasonable to assume that death was caused by a combination of the lingual thyroglossal duct cysts and asphyxia caused by being covered in bedding, though the main factor appeared to be the large cyst.
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keywords = respiration
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3/4. An unusual case of accidental smothering.

    A rare accidental death case is presented in which four pieces of packing tape adhered tightly over the nose and mouth. The notes for his experimental report, left in his room, suggested that the accident happened during his trial to prove his theory on respiration to improve physical exercise.
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4/4. Near-hanging injury in childhood: a literature review and report of three cases.

    Near-hanging injury is not an uncommon occurrence in children. Surprisingly, little discussion of this topic occurs in the pediatric literature. Previous reports note that children who present with an initial pH less than 7.2, apnea or agonal respiration, or who subsequently require mechanical ventilation, either die or survive with severe neurologic residua. We report a series of three pediatric patients aged 12 years or younger who initially presented with a combination of the above morbid criteria, all of whom survived with good neurologic outcomes. Children who suffer significant near-hanging injury should be considered at high risk to develop cerebral edema and therefore should be managed aggressively. Early cardiopulmonary resuscitation in the field is essential to reestablish cerebral blood flow. A good response to initial resuscitation is an important prognostic factor for eventual recovery. After arrival to the emergency department, therapy should include controlled hyperventilation, fluid restriction, and other supportive measures to limit intracranial pressure in high-risk patients.
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keywords = respiration
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