Stronger COE showed that ultrasound-guided catheter insertion reduced phlebitis/thrombophlebitis in adults compared with non–ultrasound-guided (5 RCTs; risk ratio [RR], 0.19; 95% credible interval, .08–.50); silicone catheters increased phlebitis/thrombophlebitis compared with nonsilicone (1 RCT; RR, 2.00; 95% confidence interval [CI], 1.26–3.17)

Ultrasound-guided catheter insertion and nonsilicone catheters effectively prevented PICC complications. The evidence for other comparisons was too uncertain to draw conclusions,