Heating the scanning environment during ultrasound upper limb mapping: Impact on arteriovenous fistula creation outcomes and sonographer's perceptions of heating method useability

Abstract

This study explores the impact on arteriovenous fistula (AVF) creation and maturation of four methods of heating the scanning environment during ultrasound upper limb mapping, and sonographer perceived useability of the environments.A retrospective audit at Orange and Bathurst hospitals involving patients who underwent ultrasound upper limb mapping (2016–2022). Patients were scanned using warm gel and three additional methods of warming. Two sonographers provided their preference and opinions on each environment. Data on AVF type, brachial artery blood flow (QBRA), AVF maturity status at 3 and 6 months and intervention within this timeframe was retrieved. Data from the three additional heated environments was combined for analysis (heated environments) against the heated gel only environment (gel environment).Eighty‐five patients met selection criteria. There was no significant difference in the proportion of successfully created AVFs between the heated and the gel environments (90% vs. 94%). A greater percentage of AVFs mapped in the heated environments reached maturity without intervention compared to the gel environment (70% vs. 48%, respectively). There was a statistically significant higher QBRA in the AVFs mapped in the heated environments (1.25 L/min) that reached maturity by 3 months without intervention compared to the gel environment (0.95 L/m; p = .008). Sonographers found a warm blanket/electric throw the easiest methods of heating the scanning environment.Using an electric throw and/or a warm blanket during ultrasound upper limb mapping is practical and optimises the scan environment, which provides surgeons with quality information that ultimately improves AVF creation outcomes.