Objective: To retrieve, evaluate, and summarize the best evidence for puncture management during the early initiation stage of autologous arteriovenous fistula (AVF) in hemodialysis patients, providing a reference for clinical nursing practice. Method: Following the “6S” pyramid model system, evidence on puncture management during the initiation stage of AVF in hemodialysis patients was retrieved from domestic and international databases. The search included clinical decision-making tools, guidelines, evidence summaries, systematic reviews, and expert consensus. The retrieval period spanned from database inception to January 2023. Four researchers screened the literature, performed quality evaluations, and extracted and integrated the evidence. Results: A total of nine articles were included, comprising one clinical decision, five guidelines, one evidence summary, one systematic review, and one expert consensus. The evidence encompassed 18 key points across six areas: team building and personnel training, timing of initial puncture, pre-puncture evaluation, puncture methods, post-puncture pressure management, and management of puncture-related complications. Conclusion: Blood purification nursing staff should combine clinical scenarios with evidence-based medicine to adopt scientific, effective, and feasible puncture management strategies during the early initiation stage of AVF. This approach aims to better safeguard the patient’s vascular access and overall treatment outcomes.
Fitzgerald JT, Schanzer A, McVicar JP, et al., 2005, Upper Arm Arteriovenous Fistula Versus Forearm Looped Arteriovenous Graft for Hemodialysis Access: A Comparative Analysis. Ann Vasc Surg, 19(6): 843–850. https://doi.org/10.1007/s10016-005-7419-y
Pisoni RL, Young EW, Dykstra DM, et al., 2002, Vascular Access Use in Europe and the United States: Results from the DOPPS. Kidney Int, 61(1): 305–316. https://doi.org/10.1046/j.1523-1755.2002.00117.x
Blood Access Working Group, Branch of Blood Purification Center Management, China, 2019, Consensus among Experts on Blood Access Used for Hemodialysis in China (The 2nd Edition). Chinese Journal of Blood Purification, 18(6): 365–381.
Xiao G, Zhang L, Zhan S, et al., 2018, Handheld Ultrasound Examination for Real-Time Guidance on Cannulation in Patients with a New Arteriovenous Fistula for Hemodialysis: A Randomized and Prospective Comparison with Standard Cannulation Technique. Chinese Journal of Blood Purification, 17(9): 633–636.
Wilmink T, Hollingworth L, Stevenson T, et al., 2017, Is Early Cannulation of an Arteriovenous Fistula Associated with Early Failure of the Fistula? J Vasc Access, 18(Suppl. 1): 92–97. https://doi.org/10.5301/jva.5000674
Hill K, Xu Q, Jaensch A, et al., 2021, Outcomes of Arteriovenous Fistulae Cannulation in the First 6 Weeks of Use: A Retrospective Multicenter Observational Study. J Vasc Access, 22(5): 726–732. https://doi.org/10.1177/1129729820954717
Hill K, Sharp R, Childs J, et al., 2020, Cannulation Practices at Haemodialysis Initiation via an Arteriovenous Fistula or Arteriovenous Graft. J Vasc Access, 21(5): 573–581. https://doi.org/10.1177/1129729819869093
Shi K, Jiang H, Wakabayashi M, 2020, Effect of Early Cannulation with Plastic Cannula on Arteriovenous Fistula Patency in Hemodialysis Patients. Blood Purif, 49(1–2): 79–84. https://doi.org/10.1159/000503678
Wilmink T, Powers S, Hollingworth L, et al., 2018, Effect of First Cannulation Time and Dialysis Machine Blood Flows on Survival of Arteriovenous Fistulas. Nephrol Dial Transplant, 33(5): 841–846. https://doi.org/10.1093/ndt/gfx278
Zhang X, Gao J, Liu S, et al., 2018, Effect of Different Puncture Directions on Early Arteriovenous Fistula Function in Hemodialysis Patients. Clinical Research and Practice, 3(31): 156–157.
Jing F, He M, Hu Y, 2022, Quality Evaluation of Children’s Medication Safety Guidelines Based on AGREE II. Chinese Evidence-Based Nursing, 8(6): 718–725.
Foster MJ, Shurtz S, 2013, Making the Critical Appraisal for Summaries of Evidence (CASE) for Evidence-Based Medicine (EBM): Critical Appraisal of Summaries of Evidence. J Med Libr Assoc, 101(3): 192–198. https://doi.org/10.3163/1536-5050.101.3.008
The Joanna Briggs Institute (JBI), 2017, Critical Appraisal Tools, viewed January 15, 2023, https//joannabriggs.org/critical-appraisaltools
AGREE Research, 2017, Appraisal of Guidelines for Research & Evaluation II Instrument, viewed January 15, 2023, https//www.agreetrust.org/wp-content/uploads/2017/12/AGREE-II-Users-Manual-and-23-item-Instrument- 2009-Update-2017
Hu Y, Hao Y, 2018, Evidence-Based Nursing (2nd Edition). People’s Health Publishing House, Beijing, 58–82.
Allon M, 2021, Overview of Hemodialysis Arteriovenous Fistula Maintenance and Thrombosis Prevention, viewed January 2, 2023, https://www.uptodate.com/contents/overview-of-hemodialysis-arteriovenous-graft-maintenance-and-thrombosis-prevention?topicRef=112108&source=see_link
National Health Commission of China, 2021, Blood Purification Standard Operating Procedure (2021 Edition), viewed January 2, 2023, http://www.nhc.gov.cn/yzygj/s7659/202111/6e25b8260b214c55886d6f0512c1e53f.shtml
Wasse H, Alvarez AC, Brouwer-Maier D, et al., 2020, Patient Selection, Education, and Cannulation of Percutaneous Arteriovenous Fistulae: An ASDIN White Paper. J Vasc Access, 21(6): 810–817. https://doi.org/10.1177/1129729819889793
Lok CE, Huber TS, Lee T, et al., 2020, KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis, 75(4 Suppl 2): S1–S164. https://doi.org/10.1053/j.ajkd.2019.12.001. Erratum in Am J Kidney Dis, 77(4): 551. https://doi.org/10.1053/j.ajkd.2021.02.002
Gallieni M, Hollenbeck M, Inston N, et al., 2019, Clinical Practice Guideline on Peri- and Postoperative Care of Arteriovenous Fistulas and Grafts for Haemodialysis in Adults. Nephrol Dial Transplant, 34(Suppl 2): ii1–ii42. https://doi.org/10.1093/ndt/gfz072. Erratum in Nephrol Dial Transplant, 35(10): 1824. https://doi.org/10.1093/ndt/gfz153. Erratum in Nephrol Dial Transplant, 35(12): 2203. https://doi.org/10.1093/ndt/gfaa106
Schmidli J, Widmer MK, Basile C, et al., 2018, Editor’s Choice - Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg, 55(6): 757–818. https://doi.org/10.1016/j.ejvs.2018.02.001
Du A, Wang Y, Zhao C, et al., 2022, Summary of the Best Evidence for Prolonging the Lifetime of Autogenous Arteriovenous Fistula. Chinese Journal of Nursing, 57(21): 2604–2610.
Wong B, Muneer M, Wiebe N, et al., 2014, Buttonhole Versus Rope-Ladder Cannulation of Arteriovenous Fistulas for Hemodialysis: A Systematic Review. Am J Kidney Dis, 64(6): 918–936. https://doi.org/10.1053/j.ajkd.2014.06.018
Liang Y, Chen Y, Tu S, et al., A Nomogram to Predict the Maturity of Arteriovenous Fistulas for Hemodialysis. Chinese Journal of Blood Purification, 18(2): 110–114.
Hu T, Zhou J, 2021, Research Advances in the Application Technology of Autologous Arteriovenous Fistulas at the Initial Stage for Hemodialysis. Chinese Journal of Blood Purification, 20(6): 395–397.
Huang N, Zhang L, 2019, Effect of Finger Pressure on Hemostasis for New Fistula After Needle Extraction and Complications of Internal Fistula. Medical Journal of National Defending Forces in Southwest China, 29(5): 552–554.