Nursing in critical care
Effectiveness of Tomazoni Measurement Method for Central Catheter Tip Positioning in Neonates: A Randomised Controlled Trial
By Regne GRS, Diniz CG, Kusahara DM and 3 others.
Abstract
Background
Accurate peripherally inserted central catheter (PICC) tip positioning in neonates remains challenging, with high rates of malposition reported using traditional measurement methods.
Aim
To evaluate the effectiveness of the Tomazoni method for PICC positioning in neonates compared with the traditional method.
Study design
Pragmatic, parallel-group randomised clinical trial with stratified block randomisation, conducted in a neonatal intensive care unit in Brazil between June 2024 and April 2025.
Results
Of 62 randomised procedures, 55 were evaluable (27 in the experimental group, 28 in the control group). Central positioning was achieved in 21 of 27 procedures (77.8%) in the experimental group versus 5 of 28 (17.9%) in the control group (p < 0.001). PICC insertion procedures assessed using the Tomazoni method were 4.36 times more likely to achieve central tip placement (RR = 4.36; 95% CI: 1.91-9.88). Catheter withdrawal was required in 3 of 27 procedures (11.1%) in the experimental group versus 16 of 28 (57.1%) in the control group (p = 0.001; RR = 0.19; 95% CI: 0.06-0.59).