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G D Leslie

Publications and source records attributed to G D Leslie.

11 recordsLinked to original sources
PubMed1996

Proximally delivered dilute heparin does not improve circuit life in continuous venovenous haemodiafiltration.

OBJECTIVE: To assess the effect on circuit life in continuous venovenous haemodiafiltration (CVVHD) by manipulating heparin dilution and point of administration. DESIGN: Repeated crossover design. Cases were randomised for first circuit and heparin dilution, after which crossovers occurred until treatment was stopped. SETTING: A 24-bed combined general and surgical intensive care unit admitting 1900 patients a year. On average, 54 cases a year receive CVVHD. PATIENTS: 26 critically ill adult patients requiring CVVHD were enrolled, 18 of whom used at least one standard circuit and one modified circuit. INTERVENTIONS: Two circuit configurations and heparin dilutions were compared. In combination A, standard CVVHD blood lines and heparin concentration (100 units/ml) were used. In combination B, heparin was delivered in a more dilute volume (10 units/ml) via a modified circuit design with an administration port immediately adjacent to the venous access. MEASUREMENTS AND RESULTS: 18 randomised crossovers of circuits A and B occurred. Mean/median circuit life for the standard heparin/circuit combination A was 20.1/17.5 (SD 14.6) and for the modified combination B 21.4/15.4 (SD 19.2). There was no significant difference between circuits (paired t-test, p = 0.8175). To identify other factors which could have influenced circuit life (platelet count, heparin dose and pre- and post-filter activated partial thromboplastin time, APTT) all circuits terminated for the reasons identified (n = 105) were analysed using linear modelling. Survival analysis was used to determine the survival function of the circuit. Pre-heparin APTT was the only factor associated with an increase in filter life (p = 0.035). The hazard rate for filter failure was 0.049/h (95% confidence interval 0.04 to 0.06), the range of time until filters failed was 1.8 to 78.5 h. CONCLUSIONS: Proximally administered dilute heparin is not associated with a significant increase in circuit life.

Acute Kidney Injury↗
PubMed1996

A position statement on resuscitation by all levels of nurse. Confederation of Australian Critical Care Nurses Inc.

As part of its brief, the CACCN Inc. Advanced Life Support (ALS) Subcommittee has been reviewing and compiling a national policy for education in ALS for nurses. We believe this is an appropriate pursuit, since critical care nurses are at the forefront of practice in this area and also care for patients receiving life-saving interventions. One of the Subcommittee's concerns is the lack of a uniform approach to the issue of resuscitation across the nursing community, despite the broad applicability of such skills to many of the diverse settings in which nurses practice. The following is a position statement aimed at setting a precedent for both Basic and Advanced Life Support practice and education in the Australian nursing context. We have distributed the statement widely to stimulate debate and, eventually, a broader acceptance of this competency for nurses. We look forward to your comments.

Australia↗