Quantifying and personalizing blood patch risk

Personalizing the Intensity of Blood Pressure Control

Personalizing blood pressure management in septic shock

This review examines the available evidence for targeting a specific mean arterial pressure (MAP) in sepsis resuscitation. The clinical data suggest that targeting an MAP of 65-70 mmHg in patients with septic shock who do not have chronic hypertension is a reasonable first approximation. Whereas in patients with chronic hypertension, targeting a higher MAP of 80-85 mmHg minimizes renal injury, ...

Transforaminal epidural blood patch.

Spinal headache is an occasional, but painful complication of epidural injection procedures due to dural puncture that allows leakage of CSF from the thecal sac, thereby reducing intracranial pressure. In the event of failure of conservative management, (e.g. abdominal binder, fluids, acetaminophen), an epidural blood patch is often used. This case report describes a patient with spinal headach...

Ultrasound-guided epidural blood patch.

A 35-YR-OLD woman presented with a postdural puncture headache for epidural blood patch. The procedure was performed in the lateral position. A curvilinear ultrasound probe with sterile cover was used to visualize the epidural space. A 20-G epidural needle was used to identify the space by the loss-of-resistance technique. Blood was then injected into the epidural space under real-time ultrasou...

Quantifying Insurance Terrorism Risk

The World Trade Center disaster was a stark reminder to the insurance industry of the potential dire consequences of accumulating high concentrations of insured value and underestimating a hazard to which they are exposed. By imposing strict coverage limits, or stopping to offer terrorism cover for large commercial policies, initial steps can be taken to address the accumulation problem. Subseq...