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

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