Belly pressure and breathing after emergency abdominal surgery in intensive care
Looks at belly pressure and breathing in ventilated adults after emergency abdominal surgery.
Plain-language title generated from the registry record
Registry title: Intra-Abdominal Pressure, Respiratory Mechanics, and Ventilator Liberation After Emergency Major Laparotomy
Key facts
- Where
- Bursa, TürkiyeSee the site
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults who had emergency open abdominal surgery and are on a ventilator in intensive care afterwards.
- Age
- 18 years or older
- Sex
- All sexes can join.
- Disease stage
- Non-traumatic emergency major open abdominal surgery (laparotomy) with the abdominal wall closed at the end of surgery, followed by direct admission to intensive care and breathing support through a tube.
- Earlier treatment
- Must be on invasive mechanical ventilation (endotracheal tube or tracheostomy) when admitted to intensive care after surgery.
- Biomarker or test result
- Must have a urinary catheter in place so that pressure in the abdomen can be measured through the bladder. Pressure and breathing measurements must be taken at the same time after intensive care admission.
Main reasons for not taking part
- Planned (elective) surgery, laparoscopic surgery, or surgery for an injury
- Open abdomen or temporary closure, or a second surgery planned within 48 hours
- Bladder or urinary problems that make pressure measurement unreliable
- ECMO support, long-term ventilator dependence, or diaphragm or nerve-muscle disease affecting weaning
- Pregnancy, or a decision for comfort-only care or limiting life-sustaining treatment
Read by machine on 13 November 2026.
Where in Türkiye
- Bursa Yuksek Ihtisas Training and Research HospitalBursa, TürkiyeContact: Ugur Duman, MDNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorTrial details
- Who runs it
- Bursa Yuksek Ihtisas Training and Research Hospital
- Trial code
- NCT07889609
- Record updated
- 26 October 2026
- Original description
This prospective observational cohort study aims to investigate the relationship between intra-abdominal pressure (IAP), respiratory system mechanics, and successful liberation from invasive mechanical ventilation in adult patients admitted to the intensive care unit (ICU) following emergency major laparotomy.Read full original descriptionShow less
Association of Intra-Abdominal Pressure With Respiratory System Mechanics and Ventilator Liberation Following Emergency Major Laparotomy: A Prospective Observational Cohort Study
This prospective observational cohort study aims to investigate the relationship between intra-abdominal pressure (IAP), respiratory system mechanics, and successful liberation from invasive mechanical ventilation in adult patients admitted to the intensive care unit (ICU) following emergency major laparotomy.
Increased intra-abdominal pressure may impair respiratory mechanics by reducing chest wall compliance, increasing airway pressures, and limiting diaphragmatic movement. These physiological changes may contribute to prolonged mechanical ventilation and difficulties in ventilator liberation.
The study will enroll 100 adult patients who undergo non-traumatic emergency major laparotomy with primary fascial closure and require invasive mechanical ventilation upon postoperative ICU admission.
Intra-abdominal pressure will be measured using a standardized intravesical technique through an existing urinary catheter. Serial measurements will be performed during the first 48 hours after ICU admission, alongside simultaneous assessments of respiratory system mechanics, including static respiratory system compliance and driving pressure.
The primary objectives are to evaluate the longitudinal association between IAP and static respiratory system compliance and to investigate whether early IAP trajectories are associated with time to successful liberation from invasive mechanical ventilation within 28 days.
Secondary outcomes include driving pressure, mechanical ventilation status on day 7, extubation failure, ventilator-free days through day 28, and mortality.
All clinical management decisions, including ventilator settings, sedation, spontaneous breathing trials, extubation, and tracheostomy, will remain under the responsibility of the treating ICU team. No study-directed therapeutic interventions will be performed.
Inclusion: Age 18 years or older; Undergoing non-traumatic emergency major abdominal surgery performed through an open laparotomy; Direct admission to the intensive care unit following surgery; Receiving invasive mechanical ventilation through an endotracheal tube or tracheostomy at the time of postoperative ICU admission; Primary abdominal fascial closure performed at the end of surgery; Presence of an indwelling urinary catheter allowing intra-abdominal pressure measurement using the intravesical technique; Availability of simultaneous intra-abdominal pressure and respiratory mechanics measurements at the initial assessment after ICU admission; Written informed consent obtained from the patient or, when the patient lacks decision-making capacity, from a legally authorized representative or an eligible relative in accordance with applicable regulations and ethics committee requirements; Additional written consent obtained from the patient for continued participation if decision-making capacity is regained during the study.
Exclusion: Elective abdominal surgery; Abdominal surgery completed laparoscopically without an open laparotomy; Open abdomen or temporary abdominal closure at the end of surgery; Planned second-look laparotomy or planned surgical reintervention within the first 48 hours; Bladder injury, previous bladder surgery, neurogenic bladder, or other urinary tract conditions that may compromise the reliability of intravesical pressure measurements; Bronchopleural fistula, significant endotracheal tube or ventilator circuit leakage, or other mechanical problems preventing reliable measurement of plateau pressure and static respiratory system compliance; Advanced neuromuscular disease, high-level spinal cord injury, or known diaphragmatic paralysis directly affecting ventilator liberation; Age younger than 18 years; Laparotomy performed for traumatic injury; Absence of invasive mechanical ventilation at postoperative ICU admission; Contraindication to urinary catheterization or inability to obtain reliable intra-abdominal pressure measurements through the urinary catheter; Extracorporeal membrane oxygenation (ECMO) support; Pre-existing dependence on chronic invasive mechanical ventilation; Pregnancy; A decision for exclusively palliative care or limitation of life-sustaining treatment at ICU admission; Refusal to participate by the patient or legally authorized representative, or inability to obtain written informed consent; Inability to obtain simultaneous baseline intra-abdominal pressure and respiratory mechanics measurements at ICU admission.