ABSTRACT
Asphyxia may refer to any condition that interferes with the uptake of oxygen or cellular utilization of oxygen. It is traditionally considered one of the modes of death. Deaths can be due to a number of causes, among which cases of suicidal hanging are the commonest across the globe. Careful and systematic autopsy along with logical evaluation of the circumstances are needed to unequivocally conclude such cases, as now it has been established that even the absence of all ‘signs’ of asphyxia is not a hindrance to conclude a death as due to asphyxial means. Respiration is a vital function involving functional synchronization between multiple systems like the respiratory, musculo-skeletal, cardiovascular and nervous system. It comprises a multi-stage process culminating in oxygen delivery from atmosphere to the peripheral tissues and the expulsion of carbon dioxide. Various factors like airway obstruction, impaired gaseous exchange, compromised respiratory movements, interference with oxygen transportation or inability of cellular utilization can lead to asphyxia. Asphyxia develops when the oxygen perfusion to tissue falls below the threshold level required for sustenance of life. Oxygen deprivation and loss of adenosine triphosphate cause neuronal death, especially in the brain stem where the vital centers of respiration and circulation are located, and this can lead to death.
