Effectiveness of subcutaneous tunneling technique in reducing PICC dislodgement and malposition:a pilot multicenter randomized controlled trial  

作　　者：Yuan Sheng Wei Gao Sheng-Yi Dongye 

机构地区：[1]School of Nursing and Rehabilitation,Shandong University,Jinan,Shandong 250012,China [2]Department of PICCs Clinic,Qilu Hospital of Shandong University,Jinan,Shandong 250012,China [3]Department of Pathology,The Second Affiliated Hospital of Shandong First Medical University,Taian,Shandong 271000,China

出　　处：《Frontiers of Nursing》2025年第1期145-153,共9页护理前沿(英文)

摘　　要：Objective:To evaluate the impact of subcutaneous tunneling on peripherally inserted central catheters(PICCs)dislodgement and malposition.Dislodged or malpositioned PICCs can lead to improper treatment.The subcutaneous tunneling strategy may be effective,but there is insufficient evidence,and proximal movement has not been explored.Methods:We randomized 630 patients who needed PICCs placement to either the tunneled PICCs(experimental group)or the non-tunneled PICCs(control group).Dislodgement and malposition of the catheter were the primary outcomes,and catheter-related infection(CRI)and catheter-related thrombosis(CRT)were the secondary outcomes.Results:Subcutaneous tunneling does not significantly reduce distal catheter movement,but it significantly reduces proximal catheter movement(4.3%vs.9.9%,P=0.007),which may explain the lower incidence of CRI(2.0%vs.5.3%,P=0.030)and CRT(3.6%vs.12.5%,P<0.001).Conclusions:Although subcutaneous tunneling does not significantly improve catheter prolapse,it should still be used clinically because proximal catheter movement can be a more serious problem associated with CRI and CRT.

关 键 词：CATHETERIZATION COMPLICATIONS peripheral adverse effects randomized controlled trial tunneled multicenter study 

分 类 号：R472[医药卫生—护理学]