Aerospace Medicine Technical Reports
FAA Office of Aerospace Medicine
Civil Aerospace Medical Institute
Report No: DOT/FAA/AM-09/3
Title and Subtitle: Determination of Etomidate in Human Postmortem Fluids and Tissues
Report Date: February 2009
Authors: Johnson RD, Lewis RJ
Abstract: Following an aviation accident, biological specimens from the operator of the aircraft are submitted to the Federal Aviation Administration�s Civil Aerospace Medical Institute for toxicological analysis. During the course of medical treatment following an aviation accident, pilots who later died as a result of their injuries may have been administered etomidate as an intravenous anesthetic.
Our laboratory has developed a sensitive method for the identification and quantitation of etomidate in the biological specimens received from these pilots. Furthermore, we have evaluated the distribution of this compound in various postmortem tissues and fluids from 3 fatal aviation accident cases. When available, 10 specimen types were analyzed for each case, including blood, urine, vitreous humor, liver, kidney, skeletal muscle, lung, spleen, heart muscle, and brain. Specimens were extracted using solid-phase base extraction and analyzed by GC/MS. Deuterated etomidate was not available as an internal standard, so to eliminate any possible matrix effects during extraction all quantitative values in specimens other than blood were determined through standard addition.
Blood etomidate concentrations in these three cases ranged from 12 to 41 ng/mL. Distribution coefficients for etomidate were determined for each of the specimen types analyzed. These coefficients are expressed relative to the blood concentration in that case.� To our knowledge, this is the first report presenting the distribution of etomidate in humans at therapeutic concentrations.
Key Words: Forensic Toxicology, Etomidate, Distribution, Postmortem, Aircraft Accident Investigation
No. of Pages: 11
Civil Aerospace Medical Institute
Report No: DOT/FAA/AM-09/3
Title and Subtitle: Determination of Etomidate in Human Postmortem Fluids and Tissues
Report Date: February 2009
Authors: Johnson RD, Lewis RJ
Abstract: Following an aviation accident, biological specimens from the operator of the aircraft are submitted to the Federal Aviation Administration�s Civil Aerospace Medical Institute for toxicological analysis. During the course of medical treatment following an aviation accident, pilots who later died as a result of their injuries may have been administered etomidate as an intravenous anesthetic.
Our laboratory has developed a sensitive method for the identification and quantitation of etomidate in the biological specimens received from these pilots. Furthermore, we have evaluated the distribution of this compound in various postmortem tissues and fluids from 3 fatal aviation accident cases. When available, 10 specimen types were analyzed for each case, including blood, urine, vitreous humor, liver, kidney, skeletal muscle, lung, spleen, heart muscle, and brain. Specimens were extracted using solid-phase base extraction and analyzed by GC/MS. Deuterated etomidate was not available as an internal standard, so to eliminate any possible matrix effects during extraction all quantitative values in specimens other than blood were determined through standard addition.
Blood etomidate concentrations in these three cases ranged from 12 to 41 ng/mL. Distribution coefficients for etomidate were determined for each of the specimen types analyzed. These coefficients are expressed relative to the blood concentration in that case.� To our knowledge, this is the first report presenting the distribution of etomidate in humans at therapeutic concentrations.
Key Words: Forensic Toxicology, Etomidate, Distribution, Postmortem, Aircraft Accident Investigation
No. of Pages: 11
Last updated: Friday, June 1, 2012