Abstract: Objective: To explore the impact of Zone Inserted MethodTM (ZIMTM) on the effectiveness of tunneled Peripherally Inserted Central Catheter (PICC). Methods: A prospective study selecting patients receiving tunneled PICC in 5 tertiary grade A hospitals in Shandong Province from July 2021 to December 2021 as subjects was carried out. The patients were divided into three groups based on the ZIMTM principle: green-red group (n=114), green-green group (n=131), and yellow-green group (n=129). Then indicators including catheter-related complications, bleeding volume within 24 hours, comfort scores of patients were compared among the three groups. Results: In the case of controlling confounding factors, less catheter dislodgement was observed in the green-green group and the yellow-green group when compared with the green-red group, and the yellow-green group also showed a significantly lower incidence of catheter-related thrombosis (P<0.05); The 24-hour bleeding at the venous puncture site and catheter exit site in the green-red group, green-green group, and yellow-green group decreased in descending order, while the comfort scores of patients increased in an opposite order (P<0.05). Conclusion: According to the ZIMTM theory, to puncture from the yellow area and exit from the green area is the most ideal placement approach for tunneled PICC, which is greatly conducive to reducing catheter-related complications and improving the comfort of patients during catheterization.

Key words: subcutaneous tunnel; Peripherally Inserted Central Catheters; Zone Insertion MethodTM; prospective study