Sympathoadrenal System as a Diagnostic Sign of a Stress-Reaction in Case of Dynamic Development of a Lethal Mechanical Trauma

Bodnar P. M., Kryvda G. F., Fylypchuk O. V.

LITERATURE REVIEWS

Scentific article

The stress state diagnostics of a body has been gaining more popularity lately, including in the cases of lethal injuries. Sympathoadrenal system takes part in various pathophysiological manifestations directly which are evident in case of a stress. This system reacts quickly to any injury and promotes mobilization of adaptation and resistance mechanisms in the body. The conducted research shows that a stress reaction is characterized by cer-tain changes in adrenal cortex functioning. Three stages of violated catecholamine exchange are distinguished in the case of a stress. The first stage is characterized by noradrenaline release from nerve endings in hypothalamus and other CNS areas as well as by ac-tivation of adrenal medulla. The second stage means long-term activation when blood adrenaline level increases at the same time with its gradual decrease in adrenal medulla. Function exhaustion is typical for the third stage when adrenaline and catecholamine levels in adrenal glands decrease. It has been proven by experts who study the contents of adrenaline and noradrenaline in blood that if sudden death is caused by natural reasons (heart failure) the adrenaline level is much lower than when death is caused by an injury. It is discovered that if the adrenaline level in cerebrospinal fluid exceeds 20 ng/ml, it proves that the death was accompanied by long-term agony, and adrenaline/noradrenalaine rate in femoral vein and heart blood increases if the duration of dying is longer. These results have also been proven during experiments with animals when the increased level of catechol-amines in blood, cerebrospinal fluid, urine and adrenal medulla was established in case of long-term agony in com-parison with the animals which died quickly because of heart failure. A large-scale investigation of the level of adrenaline, noradrenaline, dopamine in the blood from auricles of the heart and femoral veins of 542 corpses with different causes of death has shown that the contents of these sub-stances is higher in the case of a lethal injury and poisoning than in the case of sudden death. The authors state that it is connected with the degree of stress which depends on the level of sufferings when dying. The discovered significant increase of the catecholamine level in cerebrospinal fluid in the cases of asphyxia cased by hanging, when compared with the case of death due to heart failure, has been offered as a diagnostic criterion for establishing this cause of death. Examination of the level of catecholamines in the urine of the corpses and during the experiment with animals in the case of hypothermia has shown that their contents is much higher than in the case of other causes of death and for this reason it can be used as a diagnostic marker for establishing exposure to cold as the cause of death. Thus, the conducted analysis proves that sympathoadrenal system not only takes an active part in a stress reaction in the case of a lethal injury of humans but it also reflects the chronobiological picture depending on the duration of the lethal mechanical trauma. For this reason examination of the quantitative content of catecholamines in tissues and fluids of a corpse as diagnostic markers of this reaction seems to be a perspective investigation direc-tion when looking for the solutions of forensic issues. That is why further research should be intended to establishing diagnostically significant signs which help find-ing out both death genesis and duration of the stress reaction which takes place in the body in reply to the lethal effect of a traumatic factor.

sympathoadrenal system, catecholamines, injury, stress reaction

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