Effects of three peripherally inserted central catheters insertion techniques on catheterization outcomes: A...

Area of Science:

• Medical Procedures
• Vascular Access Devices
• Clinical Trials

Background:

• Current peripherally inserted central catheters (PICC) methods include traditional, one-needle, and two-needle subcutaneous tunnel techniques.
• Research often overlooks the procedural aspects of PICC insertion, focusing instead on post-catheterization complications.
• Key procedural factors like first-attempt success, patient experience, and bleeding are critical for evaluating PICC methods.

Purpose of the Study:

• To compare the procedural outcomes of traditional non-tunnel catheterization with one-needle and two-needle subcutaneous tunnel catheterization for PICC insertion.
• To evaluate the impact of different PICC insertion techniques on first-time puncture success, patient pain, and bleeding.

Main Methods:

• A three-arm, parallel, randomized controlled trial was conducted with 681 patients.
• Patients were randomized into traditional non-tunnel, one-needle subcutaneous tunnel, or two-needle subcutaneous tunnel catheterization groups.
• Primary outcomes included one-time puncture success rate, pain intensity, and total bleeding volume.

Main Results:

• One-needle and two-needle subcutaneous tunnel methods showed significantly higher one-time puncture success rates than the traditional method.
• Both tunnel methods resulted in a lower blood oozing rate within 24 hours post-catheterization compared to the traditional method.
• The traditional and one-needle methods had significantly lower total bleeding volume, pain intensity, and catheterization operating time compared to the two-needle method.

Conclusions:

• One-needle subcutaneous tunnel catheterization demonstrated superior performance over traditional and two-needle methods.
• This technique is associated with improved procedural success and patient comfort, with no reported nerve or blood vessel damage.
• One-needle subcutaneous tunnel catheterization is recommended for clinical application.