Postmortem redistribution in humans: Important variables that might be influencing the central blood/peripheral blood ratio

After death, blood drug concentrations need not match those at the time of death, partly because drugs redistribute in the body. Before death, drugs may accumulate in organs such as the liver and lungs, where levels can be several times higher than in blood, and after death they can move from these organs. The ratio of drug concentrations in femoral blood to those in cardiac blood serves as a marker of this redistribution; because cardiac blood is near organs, its concentrations may change earlier and more than femoral blood. The thesis studies how various factors may influence this ratio for several drugs, using information from death investigations by the Netherlands Forensic Institute between 2010 and 2020.