A summary of the best evidence on ultrasound-guided autologous arteriovenous fistula cannulation in maintenance hemodialysis patients: A systematic review.

OBJECTIVE

The aim of this study is to systematically retrieve, appraise, and synthesize high-level evidence related to ultrasound-guided Autologous Arteriovenous Fistula (AVF) cannulation and to develop evidence-based recommendations to support standardized and safe clinical practice in vascular access management.

METHODS

All evidence on ultrasound-guided autologous AVF cannulation were searched from January 1, 2015, to December 30, 2024, including UpToDate, DynaMed, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, National Kidney Foundation, European Society for Vascular Surgery, American Institute of Ultrasound in Medicine, Infusion Nurses Society, Joanna Briggs Institute (JBI), Medlive, PubMed, Embase, the Cochrane Library, CNKI, WanFang Data, and VIP Database. Eligible literature included clinical decision-making tools, practice guidelines, practice recommendations, evidence summaries, systematic reviews, and expert consensus statements. The quality of all included studies was assessed using appropriately critical appraisal tools.

RESULTS

A total of 20 articles were included, comprising 2 clinical decision-making documents, 9 guidelines, 4 expert consensus statements, 2 systematic reviews, 1 practice recommendations, 2 evidence summaries. Ultimately, 17 items of best evidence were synthesized, covering five major domains: Indications, vascular assessment, equipment preparation, cannulation implementation, and education and training.

CONCLUSION

This study summarized the best available evidence on ultrasound-guided autologous AVF cannulation, thereby providing scientific evidence to support clinical practice in vascular access management for hemodialysis. However, as the included studies originated from different countries, the applicability of the evidence should be carefully considered within the context of specific clinical settings to ensure standardization and safety.Reporting method:This study reported in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The protocol was prospectively registered with the Fudan University Center for Evidence-Based Nursing (Registration No. ES20257908).Patient or public contribution:No Patient or Public Contribution. This study is a systematic evidence summary based on published literature and did not involve the collection of primary data from patients or the public.