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Healio: Initiative leads to vein preservation for hospitalized children who may require dialysis

By Melissa J. Webb, MA

A quality improvement initiative resulted in increased frequency of peripheral IV placement in the dominant arm for hospitalized children with kidney disease.

According to the researchers, the improvements seen were partially due to education and increased awareness regarding the importance of vein preservation for this patient population.

“An arteriovenous fistula (AVF) in the non-dominant arm is the preferred access for hemodialysis (HD) patients,” Nisha S. Singh, MD, of the division of pediatric nephrology at Children’s Mercy Kansas City, and colleagues, wrote. 

Researchers compared data on PIV location for patients from 2017 to that following the initiative.

They found that, prior to implementation of the initiative, 47% of PIVs were placed in patients’ dominant arms; for children younger than 5 years only, 25% were placed in the dominant arm.

After the initiative, 93% of PIVs were placed in the dominant arm; for children younger than 5 years, 94% were now placed in the dominant arm.

Singh and colleagues concluded of the findings, adding “pediatric nephrology teams caring for children with CKD need to advocate for vessel preservation as part of everyday patient management."


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