Collapse
WHO data ranked the Russian Federation in the world ranking of countries for alcohol drunk fourth place. On average, there is 12 liters of alcohol per person (per year). Due to the consumption of so many strong drinks, robberies, suicides, murders, and tragedies occur on the roads. Drinking for many years remains a curse for the country.
Driving is permitted only when sober. To make sure whether a person drank or not, a blood test for alcohol will help.
Why is such a study
An alcohol test is often prescribed. The results of the research are used both for medicinal purposes and in the form of evidence during the investigation and trial.
The most common analysis among drivers. It is required for accidents. Violation of traffic rules also obliges the police to make sure that the driver is not touching hard liquors. The results will serve as proof of his absolute sobriety, or vice versa. Such studies will help to avoid disastrous consequences.
Not only drivers whose sobriety is in doubt donate blood for analysis. Often, the need for research appears when a person has severe injuries that require surgery. And it can only be carried out under general anesthesia. Since ethanol affects the effect of anesthesia, analysis is indispensable.
The reason for checking the blood for alcohol may be the inappropriate behavior of the patient. To understand the causes of a strange state of a person, a similar study needs to be done to exclude the action of ethanol.
Often, a rapid alcohol test is performed for minors. It is not new to specialists whose occupation excludes the use of alcohol.
The effect of ethanol on the blood
Once in the blood, alcohol changes its structure. First, positive changes occur - the ratio of its components becomes almost ideal. But after passing another 30 minutes in the blood, adhesion and deformation of red blood cells is observed. It takes the form of shapeless clots. This can be seen in the photo:
Blood before and after drinking alcohol
Under the influence of ethanol, an increase occurs:
- the content of lactic and uric acids;
- triglyceride concentrations. A similar phenomenon can signal the start of atherosclerotic pathology;
- total cholesterol;
- concentration of the enzyme gamma-glutamyltranspeptidase involved in the exchange of amino acids. An increase in its level signals liver pathologies.
A significant excess of the indicators may indicate either that the patient drank alcohol the day before, or signals an approach to the pathology of the internal organs. This is why blood donation should be during sobriety. Otherwise, the data will be false, the test will have to be repeated.
Methods for determining the presence of alcohol in the blood
Mandatory conditions for the study:
- Venous blood is drawn.
- The skin at the puncture site should not be wiped with alcohol-containing substances.
- The presence of disposable gloves on the hands of the health worker.
- Blood is placed inside the cleanest tubes.
Described above demonstrates these photos:
Blood sampling for analysis
The material remains in the sterilized tube
To study the material obtained, several methods are used:
- Gas chromatography.
- Enzyme analysis.
- Widmark Method.
The drug dispensary mainly uses the first two. They are recognized by experts as the most reliable and provide urgent data.
Chromatography
A popular research method is chromatography. The collected blood is placed in a special flask and hermetically closed. Inside, the evaporation of blood components occurs. The gas phase that remains after such a volatilization is investigated. It is taken with a syringe and placed in a chromatograph. The interpretation of the results is based on the presence of traces and the size of ethanol.
Enzyme analysis
During enzyme analysis, the doctor monitors the rate of degradation of the enzymes. They are produced by the liver only after a person drinks alcohol. In the absence of alcohol, enzymes are not produced and are not present in the blood sample.
The container with the studied material is placed inside a special analyzer. Data arrives in a few minutes. One microscope, even such a modern one as in the photo, will not be enough.
The method allows you to find out how long alcohol has been consumed, and whether the patient is abusing alcohol. An enzymatic analysis will confirm the fact that a person does not suffer from alcohol addiction, and drank strong drinks only now.
Widmark Method
Almost a hundred years ago, a Swedish chemist Eric Widmark developed a formula for calculating the maximum theoretically possible concentrations of ethanol in the blood. It is still relevant, and looks like this:
C is the alcohol concentration, ‰;
A - drunk, gr .;
m - weight, kg;
r is the coefficient.
To determine the ethanol content, it follows from drunk (A) to subtract from 10 ‰ to 30 ‰. This must be done because not all ethanol enters the peripheral blood.
The total amount of drink is determined by the formula:
When carrying out calculations, the time factor is not taken into account, namely, when an alcohol-containing drink is drunk.
Decoding of indicators in ppm
Using the methods described, the amount of ethanol (in ‰) that is contained in the blood is determined. Indicators showing the severity of intoxication, and their interpretation are as follows:
| ‰ | Short characteristic | Description |
| 0,00-0,49 | Sobriety | The amount of ethanol up to 0.49 ‰ is insignificant and corresponds to the level that the body can develop. Partly its synthesis occurs due to the fermentation of food containing carbon |
| 0,50-1,49 | State of euphoria | Light intoxication. How alcohol affects a person is determined visually due to such manifestations: - motor functions are impaired; - slowness of thinking and trouble with coordination; - minor speech and hearing impairment |
| 1,50-1,99 | Excitation | Average intoxication. The transitional stage between mild intoxication and serious. The reaction is slow, and mental instability. Drowsiness and a vague awareness of reality appear. He becomes unable to adequately assess the situation and the environment. |
| 2,00-2,99 | Disorientation | Severe intoxication and poisoning of the body. In a drunken person observed: - unnatural drowsiness or vice versa, aggressiveness; - noticeable speech impairment; - insensitivity to pain. A drunk person may lose consciousness |
| 3,00-3,99 | Apathy | A person is not able to move. There is severe intoxication, which is accompanied by vomiting. Most likely paralysis and coma |
| 4,00-4,99 | Severe alcohol intoxication | Consciousness is lost, the temperature decreases. If you do not provide medical care, a person may die |
| 5.00 and more | Fatal outcome | The dose of alcohol is incompatible with life. Poisoning leads to respiratory arrest, disruption of the heart, and a person dies |
The indicators for each person are individual. For one, 0.8 ‰ leads to complete disorientation, and for another 3.8 ‰ is not dangerous. An out of the ordinary case was recorded when the concentration of ethanol exceeded 9 ‰, and the hopped man survived. But this does not mean that you can expose your own body to such a risk! With great care, even low-alcohol drinks should be consumed.
Factors That Can Distort Results
Such factors can distort analyzes:
- The volume of alcohol consumed. If it was used earlier than 12 hours, then the analysis will be positive. This means that alcohol drunk yesterday will remain in the body until morning. And even if not a bit has been taken today, the test will show the opposite result.
- The time during which a drink was drunk. It is much safer to take alcohol not in one gulp, but to stretch it in time for a couple of hours.
- Fortress. Low alcohol drinks are excreted from the bloodstream into the urine much faster. Concentrated alcohol stays 3-4 times longer.
Therefore, a strong drink drunk in one gulp in large quantities will leave its marks in the blood one day after consumption, distorting the results of the analysis.
There are also such factors:
- The use of drugs that contain alcohol.
- Ethanol entering the blood sample from the treated skin site.
- The increased content of ketones, which is a consequence of metabolic disorders.
- Blood diseases in which hemoglobin and red blood cells are significantly lower than normal.
Despite the possible error, a blood test remains the most informative for determining the sobriety of a person, and confirms or refutes alcoholism.
You can voluntarily take the analysis by contacting the nearest medical rehabilitation center or drug dispensary. Urgent result - at an additional cost.
Measurement of alcohol in the blood - a study whose results can affect the future fate of a person. The test should be carried out carefully so that its data correctly reflects the level of ethanol and the degree of intoxication. Where to donate blood voluntarily, a person decides for himself.
Video
The video tells about the features of the study:
← Previous article Next article →Any alcoholic drink contains, to a greater or lesser extent, the main component - ethyl alcohol (ethanol). As you know, alcohol is a good solvent and is widely used in industry. But, getting into the bloodstream, he behaves there in a similar way, and begins to instantly change its property, and with blood flow enters the brain and other organs.
This biological material consists of plasma and cells, one of them is red blood cells. They are called red blood cells in a different way, the main function of which is gas exchange, due to the hemoglobin contained inside. Red cells are elastic and coated with grease, which allows them to easily move even through the smallest vessels of the body, saturating all organs and tissues with oxygen. And thanks to a unipolar negative charge, red blood cells repel each other.
At the initial stage of intoxication, alcohol dilutes blood and dilates blood vessels, but this effect is short-lived. Then there is a vasospasm. Alcohol removes the electric charge and erases the grease from the red cell, as a result of which red blood cells stick together. This means that alcohol has a thrombogenic property and increases blood coagulation.
The diameter of one red blood cell varies from 7 to 10 microns, and the smallest diameter of the brain capillary is 8 microns. Accordingly, when gluing of red blood cells occurs, they form large blood clots that clog small vessels of organs. As a result, the brain is in a state of oxygen deficiency (hypoxia). As intoxication, hypoxia is perceived, part of the brain is simply disconnected from full work, a person experiences euphoria and freedom. Sleep while intoxicated is an alcoholic coma, the body's reaction to hypoxia.
Red blood cell clots contain an average of 200-500 cells. Blood clots can clog not only very small vessels, so any organ can be affected. Addiction (addiction) is able to chronically change indicators.
Blood alcohol measurement
The amount of ethanol is measured in ppm. 1 ppm is equal to 1 ml of pure ethyl alcohol in 1000 ml of blood, and is indicated by знаком.
The degree of intoxication in ppm:
- The first degree is easy. 0.5 - 1.5 ‰. It occurs a few minutes after drinking. Muscle relaxes, fatigue disappears, mood rises and activity increases.
- The second degree is medium. 1.5 - 2.5 ‰. Speech becomes less expressive, coordination of movements decreases. It is in the medium degree of intoxication that a person is attracted to various adventures and disassemblies, and aggressiveness increases.
- The third degree is severe. 2.5 - 3 ‰. Disturbed speech and coordination. Possible loss of consciousness. This stage is often accompanied by amnesia.
- The fourth degree is extremely difficult. 3-4 ‰. A person is not able to move and talk. At this stage, a person does not recognize other people and does not understand what is happening at all.
- The fifth stage is the lethal content of ethanol. 5-6 ‰. Damage to the nervous system, heart and liver. The body can not cope with such a strong intoxication.
In some cases, a fatal outcome is also possible with an ethanol content of less than 5-6 ppm. It depends on the weight of the person, physical condition, the presence of various diseases, in particular, pathologies of the gastrointestinal tract, liver, cardiovascular system. The reaction to the degree of intoxication in ppm is individual.
Promille driving
During the examination for intoxication, breathalyzers are used. They analyze vapors of ethanol in exhaled air. Alcohol can be measured both in exhaled air and in biological fluid. The norm of alcohol in the blood of the driver (in the territory of the Russian Federation) is approximately 0.3 ‰, which is 0.16 mg / l in air. In what measurements are taken - not fundamentally, most importantly, the indicator itself.
Deciphering the relationship between the content of ethyl alcohol in the blood and in exhaled air:
| Index in ppm ‰ | Exhaled mg / L |
| 0.1 | 0.045 |
| 0.2 | 0.09 |
| 0.3 | 0.135 |
| 0.4 | 0.18 |
| 0.5 | 0.225 |
| 0.6 | 0.27 |
| 0.7 | 0.315 |
| 0.8 | 0.36 |
| 0.9 | 0.405 |
| 1.0 | 0.45 |
| 1.1 | 0.495 |
| 1.2 | 0.54 |
| 1.3 | 0.585 |
| 1.4 | 0.63 |
| 1.5 | 0.675 |
| 1.6 | 0.72 |
| 1.7 | 0.765 |
| 1.8 | 0.81 |
| 1.9 | 0.855 |
| 2.0 | 0.9 |
| 2.1 | 0.945 |
| 2.2 | 0.99 |
| 2.3 | 1.035 |
| 2.4 | 1.08 |
| 2.5 | 1.125 |
| 2.6 | 1.17 |
| 2.7 | 1.215 |
| 2.8 | 1.26 |
| 2.9 | 1.305 |
| 3.0 | 1.35 |
| 3.1 | 1.395 |
| 3.2 | 1.44 |
| 3.3 | 1.485 |
| 3.4 | 1.53 |
| 3.5 | 1.575 |
| 3.6 | 1.62 |
| 3.7 | 1.665 |
| 3.8 | 1.71 |
| 3.9 | 1.755 |
| 4.0 and higher | 1.8 and higher |
The alcohol in the driver’s blood should not exceed 0.16 (the norm in Russia). Many are interested in the safe border of drinking. Of course, safe driving is only possible in a completely sober state, when the percentage of alcohol is physiologically low.
In the presence of 0.3-0.5 ppm of alcohol in the blood, the reaction slows down, the accuracy of driving is lost. There is a tendency to overspeeding. The perception of the distance to various objects, especially moving vehicles, is impaired. There is no distance.
At 0.5-0.8 ‰ alcohol while driving - a violation of coordination of movements leads to errors in control, the feeling of distance to various objects is lost. Traffic lights are not adequately evaluated.
Blood test for alcohol
This analysis is most often used in forensic medicine and provides more reliable and accurate information than the study of exhaled breath with an alcohol meter. Diagnostics for alcohol in road accidents is also carried out.
There are 3 methods for determining residual ethanol - gas chromatography, enzyme analysis and Widmark method. The first 2 methods show the residue of alcohol most accurately.
In addition to the detected ethanol, various blood parameters change: uric and lactic acid levels increase, triglycerides and cholesterol levels increase, the average volume of red blood cells is increased, the gamma-glutamyl transpeptidase enzyme is also higher than normal.
It should be understood that a blood test for alcohol will not show how long a person drank. The value is the determination of alcohol only at the time of collection of biological material, because its concentration is gradually reduced.
The time for alcohol to withdraw from the body
The time taken to remove ethyl alcohol depends on many factors: age and gender, quantity and strength of the drink used, the quality of the drink and the snack, and the metabolic characteristics. Human mass plays the most significant role. 300 grams of vodka for a person weighing 45 and 110 kg - the difference is enormous.
Alcohol withdrawal table:
| Drink | number | Weight 60 kg | Weight 70 kg | Weight 80 kg | Weight 90 kg | Weight 100 kg |
| Beer 6% | 100 gr | 52min | 45min | 39min | 35min | 31min |
| 300 gr | 2h 37min | 2h 14min | 1h 57min | 1h 44min | 1h 34min | |
| 500 gr | 4h 21min | 3h 44min | 3h 16min | 2h 54min | 2h 37min | |
| Champagne and wine | 100 gr | 1h 36min | 1h 22min | 1h 12min | 1h 4min | 57min |
| 300 gr | 4h 47min | 4h 46min | 3h 35min | 3h 11min | 2h 52min | |
| 500 gr | 7h 59min | 6h 50min | 5h 59min | 5h 19min | 4h 47min | |
| Vodka 40% | 100 gr | 5h 48min | 4h 58min | 4h 21min | 3h 52min | 3h 29min |
| 300 gr | 17h 24min | 14h 55min | 13h 03min | 11h 36min | 10h 26min | |
| 500 gr | 29h | 24h 51min | 24h 45min | 19h 20min | 17h 24min | |
| Cognac 42% | 100 gr | 6h 5min | 5h 13min | 4h 34min | 4h 4min | 3h 39min |
| 300 gr | 18h 16min | 15h 40min | 13h 42min | 12h 11min | 10h 58min | |
| 500 gr | 30h 27min | 26h 06min | 22h 50min | 20h 18min | 18h 16min |
In people with a large weight, intoxication begins more slowly, but the time for alcohol withdrawal is faster. In women, the level of alcohol in the blood decreases more slowly than in men. The condition of the internal organs also affects the excretion of ethanol. The indicators of the table are general and conditional, and the body of each person is individual.
Alcohol is the strongest poison, and instantly changes the state and parameters of the blood with which it enters all organs and tissues of the body. When drinking alcohol, you can pre-calculate the ppm, and with a breathalyzer, monitor the degree of intoxication, especially if you have to drive a vehicle. With accuracy, alcohol in the blood at a given time can only show analysis. Addiction to alcohol leads to chronic pathology and thrombosis.
They ask me about a new diagnostic testing technique for chronic alcohol abuse. This is a blood test for CDT - this is a determination of the fraction of transferrin (diagnosis of alcohol abuse). Indeed, is it possible to diagnose chronic alcohol abuse through qualitative and quantitative analysis of carbohydrate-deficient transferrin (CDT) by capillary electrophoresis?
I must say right away that I have no experience with this method. New orders require cDT definition In many cases:
The fact is that the examination is very expensive (according to my readers, from 3.5 to 6 thousand rubles), equipment for determining CDT, kits of reagents and supplies cost millions of rubles. Not every region has such money in the budget.
But, judging by your questions, the method of qualitative and quantitative analysis of carbohydrate-deficient transferrin (CDT) for testing for chronic alcohol abuse in Russia began to be widely used. Typically, Sebia's automatic Minicap or Capillarys capillary systems and reagent kits are used. Let's figure it out together?
Narcologists say that the CDT marker allows you to identify chronic alcoholism at an early stage, including forms of latent or latent alcoholism, to differentiate it from moderate or episodic alcohol consumption. In addition, it provides monitoring of the effectiveness of the therapy through an objective reflection of remission or the occurrence of a breakdown.
To do this, laboratory testing (screening) of blood serum is performed to identify and quantify a marker of chronic alcohol abuse - carbohydrate-deficient transferrin (CDT).
Analysis of carbohydrate-deficient transferrin allows you to identify the use of high doses of alcohol equivalent to 50 - 80 g (0.6 l of wine, or 1.5 l of beer, or 0.2 l of strong 40-degree alcohol) and more absolute ethyl alcohol per day for a week or more.
The biological marker of CDT is the only marker for assessing chronic alcohol load.
When to use the definition of CDT in serum?
When registering patients with alcoholism, laboratory confirmation of the fact of chronic alcohol consumption is very important (positive result of the CDT test).
To objectify the control of remission of a patient with alcoholism and make a decision to remove it from the register, confirmation of the absence of facts of alcohol intake over a long period of time is necessary. The stability of remission is confirmed in the case of negative results of the CDT test during the entire period of dispensary registration.
Screening for chronic alcohol abuse is important for workers whose professional activities are at increased risk to others. Determination of alcohol in exhaled air with the help of Alcometers is ineffective, since the subject can always prepare for a scheduled examination by a narcologist. Determining the level of CDT, on the contrary, is a more effective means of assessing chronic alcohol abuse, since the half-life of the marker is at least 14-17 days.
Remember to get a negative result. CDT alcohol You can not take at least two weeks! A single dose of high doses of alcohol does not cause an increase in this indicator. Taking medications (antidepressants, disulfiram) does not cause changes as a result of this analysis.
The use of this method in adolescent narcology is very important. Indeed, in the early stages of the development of alcohol dependence, it is almost impossible to diagnose it with the help of clinical signs. Identification of an increased level of CDT allows a high degree of probability to confirm the fact of chronic abuse, including at the prodrome stage, when the clinical manifestations of alcoholism are still completely absent, and the effectiveness of treatment and prophylactic measures is maximum.
How is the analysis procedure for carbohydrate-deficient transferrin (CDT)?
Blood is drawn from the superficial vein into a plastic disposable tube with a tightly screwed cap without anticoagulants. The use of tubes with EDTA or citrate is not allowed. The sample volume sufficient for the study is 2-4 ml. Serum is allowed for analysis when stored in a refrigerator at a temperature of 2-8 ° C for no more than 10 days.
This study is more specific for men than for women. An analysis is not recommended for women during menstruation and during pregnancy, as well as in people with severe chronic liver damage (cirrhosis, carcinoma, active chronic hepatitis).
Important! In case of disagreement of the examined person with a positive result of the study, as well as in the case of receiving a positive result, the quantitative values \u200b\u200bof which correspond to the "gray zone" (1.3% ≤ CDT ≤ 1.6%), a second study should be appointed with a fresh serum sample after 3- 4 weeks.
According to the results of the analysis, the psychiatrist-narcologist draws up a “Conclusion of a medical institution on screening for chronic alcohol abuse”.
How to interpret the results of a blood test for CDT?
It is important that the study protocol must necessarily contain a graphic curve with the image of transferrin isoform profiles.
The conclusion on the results of the study without a qualitative assessment protocol (schedule) is considered invalid.
A CDT value of more than 1.3% is regarded as an indicator of chronic alcohol abuse (positive).
CDT value< 1,3 % расценивают как отрицательный результат.
When obtaining values \u200b\u200bin the range of 1.3% ≤ CDT ≤ 1.6% (“gray zone”), it is recommended to re-examine after 3-4 weeks using a sample of fresh serum from the same patient.
Could there be a “false positive” CDT blood test result?
Yes, it is possible with the following diseases:
- CDG syndrome is a rare inherited disorder.
- Primary biliary cirrhosis.
- Active chronic hepatitis.
- Liver cell carcinoma.
- High iron deficiency (anemia).
- Hemochromatosis, especially during periods of intense iron depletion.
- Pancreas and kidney transplantation.
A blood test for alcohol (CDT, CDT), of course, has a right to be. It is specific and informative. Probably the future lies with him. In the meantime, I am waiting for the opinions of my colleagues about this method of diagnosing chronic alcohol abuse and, of course, your questions!
A blood test for alcohol is the most informative laboratory method for proving the presence of ethanol in the human body.
Will a blood test show alcohol?
Before taking a blood test for alcohol, it should be remembered that susceptibility is individual. And even in a situation where a person does not feel any symptoms of intoxication, the result will still show the presence of alcohol in the body. Since alcoholic beverages distort the results of laboratory tests, medical experts recommend that you give up drinking alcohol two or three days before the blood test.
Training
The analysis does not require special preparation. For this study blood is taken from a vein. If we talk about the permitted norms of alcohol content, then an indicator such as 0.2 ppm is dangerous. If the indicator exceeds 0.5 ppm, then this indicates dangerous health effects and a threat to life.
According to statistics, the highest concentration of alcohol in the blood (0.9 ppm) was recorded in a patient who, due to alcohol intoxication, was at death, but the doctors still managed to bring him back to life.
Indications
A blood test for alcohol, most often, is given by drivers. But there are many other categories of workers who are not allowed to perform their duties without a certificate of the absence of alcohol in the blood, because alcohol can cause inhibition of the reaction and some other unpleasant moments that adversely affect the work process. As for the drivers, this group of people is controlled especially carefully, since on the road a person must completely control both himself and his car.
The effect of alcohol on the circulatory system
A number of factors affect the blood test, the main of which are: stress, drinking, food, and alcohol. Alcohol, as a rule, affects the final results of the study, therefore, medical specialists are extremely categorical in this matter. Exclude alcohol from the diet is necessary for 48-72 hours before the test. If this is not done, the picture of the study will be noticeably distorted. Under the influence of ethanol in the blood, the following changes are observed:
- the concentration of triacylglycerides increases;
- increased lactate content;
- glucose level falls;
- the amount of uric acid increases.
In addition, ethanol contributes to the destruction of red blood cells. In many people who abuse alcohol, cholesterol levels increase by 80% in the membranes of red blood cells. As a result, due to a decrease in the number of red blood cells, the hemoglobin concentration also decreases.
Alcohol also worsens plasma performance, since the liver produces less lipids under the influence of ethanol (and these data are considered very important in preparing for surgery and for healing complex wounds).
If we talk about a biochemical analysis of blood, then the use of alcohol greatly distorts the results of this study. For example, helps lower glucose. In this case, the diabetic on the meter will see a normal indicator.
In a word, a doctor, considering the results of a blood test, before the delivery of which a dose of alcohol was taken, may be mistaken in the diagnosis. Therefore, after a stormy, as well as a light party, it is better to wait two or three days until all indicators resume, and only after that go for an examination.
Alcohol susceptibility
Everyone should know that the susceptibility to alcohol is very individual. It is explained by the fact that in the human body, alcohol holds for a certain period of time, which provides various external manifestations of intoxication. According to medical experts, the ethanol release time from the human body depends on the following factors:
- the amount of alcohol consumed;
- the degree of fullness of the stomach before drinking alcohol;
- condition of internal organs;
- number of snacks;
- drink strength.
The main factor on which the speed and severity of intoxication depends is weight. Practice has shown that the lower the weight, the faster the intoxication occurs, and the slower the alcohol is removed from the body. In women, this happens much longer than in the stronger sex. Impaired functioning of internal organs also contributes to ethanol retention in the blood. In addition, studies have shown that spirits are excreted four times longer than low alcohol drinks.