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Aim: To assess the improvements during patient follow-up after implementing a proactive plan for retrieval of inferior vena cava (IVC) filters.Materials and Methods: A retrospective study was undertaken including all patients who had a temporary IVC filter inserted over a 10-year period. Patient demographics, insertion dates, retrieval dates, retrieval rates, and complications were recorded. Patients were categorised into three groups as follows: group A, no intervention where retrieval was not suggested; group B, passive intervention where retrieval was suggested but no appointment made; and group C, proactive intervention where a retrieval date was booked by the radiologist.Results: Five hundred and nine patients had a temporary IVC filter inserted at Royal Liverpool University Hospital over the study period. One per cent of patients in group C were lost to follow-up compared to 41% and 29% in groups A and B respectively (p<0.001). The number of patients who had an IVC retrieval attempt also increased to 80% in group C compared to 53% and 64% in groups A and B (p<0.001).Conclusion: Incorporation of a proactive retrieval booking system has significantly reduced the number of patients lost to follow-up to 1%, leading to an increased number of IVC filter retrieval attempts. [ABSTRACT FROM AUTHOR]

Background: Infection is one of the major factors that determine clinical outcome among patients requiring intensive care unit (ICU) support. The attending mortality is high and depends on source of infection, organisms associated, timeliness and appropriateness of the treatment received. Methods&Materials: Case records of patientswhowere admitted into our 5bedded ICU over a 4 year period were retrospectively reviewed. The average number of admission was 20 per month. A preformed questionnaire was administered and data on clinical and microbiological profile of all the patients with documented infection was obtained. Results: Eighty four episodes of infections were identified in 76 patients. Road traffic accident 29/76(38.2%) and pulmonary embolism12/76(15.8%) were the leading cause of admission. The most common infection was skin and soft tissue infection (SSI) 30/84(35.7%) followed by UTI 23/84(27.4) and primary bacteraemia 18/84(21.4) with the least beingVAP3/84(3.6%). Most of the cases of UTI occurred in patients with RTA and renal failure, while the highest number of primary bacteraemia was seen among patients with burns and renal failure. The most frequent isolates were S. aureus 35/84(41.7%), K. pneumonia 18/84(21.4%) and E. coli 13/84(15.5%). K. pneumonia 2/5(40%) and P. aerugenosa 1/5(20%) were the leading cause of pneumonia, while S. aureus was the commonest cause of SSI 16/30(53.3%), primary bacteremia 10/18(55.6%) and line infection 5/5(100%). There were 3 cases of VAP one each caused by K. pneumonia, P. aerugenosa and S. aureus. High rate of resistance to cloxacillin 19/35(54.3%) and co-trimoxazole 17/26(65.4%) was noted among the S. aureus isolates. All the enterobactrecae isolates that were tested against meropenem were fully susceptible, while resistance rate to ceftriaxone was high; E. coli 5/9(55.6%), K. pneumoniae 10/14 (71.4%) and proteus spp 2/4 (50%). With exception to meropenem and colistin, ciprofloxacin had a better resistance profile against P. aerugenosa and isolated enterobactriacae compared to the other tested B-lactam agents. Conclusion: The study underscores the need to improve infection control practice in our ICU. Resistance to commonly used antibiotic was high and this makes the choice of empiric antibiotic difficult, hence measures to curtail the emergence of resistance pathogens need to be adopted. [ABSTRACT FROM AUTHOR]