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Effects of Different PICC Catheterization Methods: A Multicenter Randomized Controlled Trial

25. august 2026 opdateret af: Zeyin Hu, Sun Yat-sen University
This study aims to compare the clinical effectiveness of three PICC (Peripherally Inserted Central Catheter) insertion methods: conventional non-tunneled PICC, one-needle tunneled PICC, and two-needle tunneled PICC. This is a multicenter randomized controlled trial involving 11 hospitals in China, with a total of 801 patients scheduled to undergo PICC insertion for the first time. Patients will be randomly assigned in a 1:1:1 ratio to the three groups. The primary outcome is the incidence of post-insertion complications (including oozing, infection, thrombosis, catheter dislodgement, etc.) within 90 days. Secondary outcomes include one-time puncture success rate, pain level (NRS), bleeding volume, catheterization time, and unplanned catheter removal rate. The results will provide evidence for selecting the optimal PICC insertion method in clinical practice.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This study adopts a prospective, multicenter, three-arm, parallel-group randomized controlled design. A total of 801 patients will be recruited from 11 hospitals and randomly assigned in a 1:1:1 ratio to the three groups. The control group receives conventional non-tunneled PICC insertion. Experimental group 1 receives one-needle tunneled insertion (the needle travels subcutaneously for 4 cm before entering the vessel). Experimental group 2 receives two-needle tunneled insertion (with a 4 cm subcutaneous tunnel created using a tunneling tool). All insertions are performed by certified PICC nurses with over 5 years of experience who have received standardized training. The primary outcome is the overall incidence of catheter-related complications within 90 days post-insertion. Secondary outcomes include one-time puncture success rate, NRS pain score, intraoperative bleeding volume, catheterization time, and unplanned catheter removal rate. Outcome assessors and data analysts are blinded to group allocation. The study has been approved by the Ethics Committee of Sun Yat-sen University Cancer Center (Approval No. B2026-467-01, dated August 10, 2026).

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

801

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiekontakt

Studiesteder

    • Guangdong
      • Guangzhou, Guangdong, Kina, 510000
        • Sun Yat-sen University Cancer Center
        • Kontakt:

Deltagelseskriterier

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Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

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Beskrivelse

Inclusion Criteria:

  • Age 18 to 75 years
  • Education level of primary school or above, with adequate reading, writing and --communication skills to independently complete the questionnaire
  • First-time PICC insertion using a 4Fr single-lumen solo PICC catheter
  • Able to attend follow-up visits at the same hospital for catheter maintenance after insertion
  • Willing to participate in the study and sign the informed consent form and PICC insertion consent form

Exclusion Criteria:

  • Coagulation dysfunction (INR > 1.5 or PLT < 25 × 10⁹/L)
  • Use of anticoagulants (e.g., warfarin, heparin) within 3 days before catheterization
  • Pregnant or lactating women
  • BMI < 18.5 kg/m²
  • Patients requiring lower extremity PICC insertion
  • Known or suspected allergy to components of the PICC catheter

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Conventional Non-Tunneled PICC catheterization
Patients receive conventional non-tunneled PICC insertion. The procedure involves ultrasound-guided vein puncture, guidewire insertion, local anesthesia and skin dilation, followed by sheath and catheter advancement. The catheter exit site is at the puncture site.
Ultrasound-guided vein puncture, followed by guidewire insertion, local anesthesia, skin dilation, sheath advancement, and catheter delivery. The catheter exit site is at the puncture site with no subcutaneous tunnel created.
Eksperimentel: One-Needle Tunneled PICC catheterization
Patients receive one-needle tunneled PICC insertion. The puncture needle travels subcutaneously for 4 cm before entering the vessel, creating a subcutaneous tunnel. The skin puncture and catheter exit sites are the same. This technique requires only one needle pass for both tunneling and vessel puncture.
The puncture needle travels subcutaneously for 4 cm before entering the vessel, creating a subcutaneous tunnel with a single needle pass. The puncture site and catheter exit site are the same. This technique combines tunneling and vessel puncture in one step.
Eksperimentel: Two-Needle Tunneled PICC catheterization
Patients receive two-needle tunneled PICC insertion. Ultrasound-guided vein puncture is performed first, followed by creation of a 4 cm subcutaneous tunnel using a tunneling tool. The puncture site and catheter exit site are separate, with a subcutaneous tunnel connecting them.
A two-step procedure: first, ultrasound-guided vein puncture is performed; then, a separate subcutaneous tunnel of 4 cm is created using a tunneling tool. The puncture site and catheter exit site are separate, connected by a subcutaneous tunnel. The catheter is pulled through the tunnel from the exit site to the puncture site.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Overall Incidence of Catheter-Related Complications Within 90 Days Post-catheterization
Tidsramme: From catheterization to 90 days post-catheterization
The composite endpoint includes: oozing/exudation at the catheter exit site, mechanical phlebitis, catheter-related bloodstream infection, local or tunnel infection, catheter-related thrombosis, catheter dislodgement or migration, catheter occlusion, contact dermatitis, and catheter breakage or damage. All complications are assessed from the day of insertion up to 90 days post-insertion.
From catheterization to 90 days post-catheterization

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
One-Time Puncture Success Rate
Tidsramme: Day 1 During catheterization procedure
Proportion of patients in whom the first puncture successfully enters the vein and the guidewire is smoothly advanced.
Day 1 During catheterization procedure
Pain Intensity During Catheterization (NRS Score)
Tidsramme: Day 1 Immediately after catheterization procedure
Pain level assessed using the Numeric Rating Scale (NRS, 0 = no pain, 10 = worst imaginable pain) immediately after catheterization.
Day 1 Immediately after catheterization procedure
Intraoperative Bleeding Volume
Tidsramme: Day 1 From start to end of catheterization procedure
Total bleeding volume during catheterization, calculated by weighing gauze pads before and after the procedure (converted using whole blood specific gravity of 1.05 g/mL).
Day 1 From start to end of catheterization procedure
Catheterization Procedure Time
Tidsramme: Day 1 During catheterization procedure
Time from the first skin puncture to the moment the catheter is delivered to the predetermined length.
Day 1 During catheterization procedure
Unplanned Catheter Removal Rate
Tidsramme: From Day 1 catheterization to 90 days post-catheterization
Proportion of catheters removed prematurely due to complications (e.g., infection, thrombosis, dislodgement, occlusion) before the completion of treatment.
From Day 1 catheterization to 90 days post-catheterization

Samarbejdspartnere og efterforskere

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Sponsor

Samarbejdspartnere

Datoer for undersøgelser

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Studer store datoer

Studiestart (Anslået)

10. september 2026

Primær færdiggørelse (Anslået)

30. maj 2027

Studieafslutning (Anslået)

30. august 2027

Datoer for studieregistrering

Først indsendt

25. august 2026

Først indsendt, der opfyldte QC-kriterier

25. august 2026

Først opslået (Faktiske)

28. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

28. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • Different PICC catheterization

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