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

25 de agosto de 2026 actualizado por: 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.

Descripción general del estudio

Descripción detallada

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).

Tipo de estudio

Intervencionista

Inscripción (Estimado)

801

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

  • Nombre: Zeyin Hu
  • Número de teléfono: 86+15899954190
  • Correo electrónico: huzy@sysucc.org.cn

Ubicaciones de estudio

    • Guangdong
      • Guangzhou, Guangdong, Porcelana, 510000
        • Sun Yat-sen University Cancer Center
        • Contacto:

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Adulto
  • Adulto Mayor

Acepta Voluntarios Saludables

No

Descripción

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

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Prevención
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Doble

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Comparador activo: 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.
Experimental: 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.
Experimental: 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.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Overall Incidence of Catheter-Related Complications Within 90 Days Post-catheterization
Periodo de tiempo: 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

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
One-Time Puncture Success Rate
Periodo de tiempo: 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)
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

10 de septiembre de 2026

Finalización primaria (Estimado)

30 de mayo de 2027

Finalización del estudio (Estimado)

30 de agosto de 2027

Fechas de registro del estudio

Enviado por primera vez

25 de agosto de 2026

Primero enviado que cumplió con los criterios de control de calidad

25 de agosto de 2026

Publicado por primera vez (Actual)

28 de agosto de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

28 de agosto de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

25 de agosto de 2026

Última verificación

1 de agosto de 2026

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • Different PICC catheterization

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

INDECISO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

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