Effectiveness of Tomazoni Measurement Method for Central Catheter Tip Positioning in Neonates: A Randomised Controlled Trial.
Giulia Ribeiro Schettino Regne, Catharine Galvão Diniz, Denise Miyuki Kusahara et al.
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In 30 seconds
This pragmatic, parallel-group randomised controlled trial compared the Tomazoni and traditional measurement methods for positioning peripherally inserted central catheter (PICC) tips in neonates at a Brazilian neonatal intensive care unit. Among 55 evaluable procedures, central tip placement was achieved in 21 of 27 procedures (77.8%) with the Tomazoni method and 5 of 28 (17.9%) with the traditional method (p < 0.001). The Tomazoni group also required fewer catheter withdrawals. The findings indicate improved positioning outcomes with the Tomazoni method in this trial.
Key findings
- Central tip placement occurred in 21 of 27 procedures (77.8%) with Tomazoni measurement versus 5 of 28 (17.9%) with traditional measurement (p < 0.001).
- Tomazoni-measured procedures 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%) versus 16 of 28 (57.1%) (p = 0.001; RR = 0.19; 95% CI: 0.06-0.59).
Why it matters
PICC tip malposition can prompt catheter manipulation, and accurate placement is a practical challenge in neonatal care. In this randomised trial, the Tomazoni method was associated with more central placements and fewer withdrawals than the traditional method. These outcomes make the measurement approach relevant to efforts to improve initial positioning and limit procedure-related catheter manipulation.
What to keep in mind
Only 55 of 62 randomised procedures were evaluable, and the trial was conducted in a single neonatal intensive care unit in Brazil.