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Pathology of Asphyxial Death

Overview

“Asphyxia” is a term derived from Greek that literally translates as “stopping of the pulse.” This term refers to a multi-etiologic set of conditions in which there is inadequate delivery, uptake and/or utilization of oxygen by the body’s tissues/cells, often accompanied by carbon dioxide retention.

Traditionally, the conditions leading to asphyxia have included breathing an oxygen-deficient atmosphere and/or interference with the act of breathing (ie, inhaling and exhaling) and/or respiration (ie, gas exchange and the utilization of oxygen). Conditions that historically were thought to involve airway compromise but are now recognized to involve restriction of blood flow or altered hemodynamics (eg, hanging, strangulation, and compression asphyxia) continue to be classified as asphyxia.

Although many natural disease processes may involve inadequate uptake and/or delivery of oxygen (eg, chronic obstructive pulmonary disease [COPD]), the term “asphyxia” is generally reserved for conditions related to abnormal atmosphere and mechanical and chemical effects directly leading to the aforementioned abnormalities.

Determination of the specific type(s) of asphyxia operative in a particular case, the cause of death, and the manner of death is dependent on information elicited during the medicolegal death investigation—namely, history (circumstances), scene investigation, and postmortem examination (including appropriate ancillary radiographic and laboratory studies).

See also the following:

Autopsy Request Process

Adjuncts to the Forensic Autopsy

Religions and the Autopsy

Autopsy of the Transplant Recipient

Autopsy Rate and Physician Attitudes Toward Autopsy

Universal Precautions and High-Risk Autopsies

Autopsy Quality Control Metrics

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