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Association of High Positive End-Expiratory Pressure with Intra-Abdominal Pressure and Urine Output in Critically III Patients: A Prospective Observational Study

Nureddin Yuzkat.


Abstract
Background: This study evaluated the association between high positive end-expiratory pressure (PEEP) and hourly urine output and intra-abdominal pressure (IAP) in critically ill patients receiving mechanical ventilation.
Materials and Methods: This single-center, prospective observational study included 40 adult patients who were expected to require invasive mechanical ventilation for at least 24 hours. We classified patients into a low-PEEP group (4–6 cmH₂O; n=20) and a high-PEEP group (14–16 cmH₂O; n=20) based on the PEEP level prescribed as part of routine clinical care. We recorded body weight-normalized hourly urine output and measured IAP using the intravesical technique at baseline and at 12 and 24 hours. We analyzed data using two-way repeated-measures analysis of variance.
Results: No significant group effect [F(1,38)=0.61; p=0.441], time effect [F(2,76)=0.22; p=0.804], or group-by-time interaction [F(2,76)=0.25; p=0.781] was observed for hourly urine output. IAP showed a significant group effect [F(1,38)=5.99; p=0.019], with an estimated marginal mean difference of 2.17 mmHg between the high- and low-PEEP groups. IAP also increased over time [F(2,76)=6.65; p=0.002]. Recurrent intra-abdominal hypertension was more frequent in the high-PEEP group than in the low-PEEP group (45% vs 10%; p=0.031).
Conclusion: High PEEP was not associated with a significant reduction in hourly urine output during the 24-hour observation period; however, it was associated with higher IAP.

Key words: Positive-Pressure Respiration; Intra-Abdominal Hypertension; Urine; Respiration, Artificial; Critical Care


 
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Pubmed Style

Nureddin Yuzkat. Association of High Positive End-Expiratory Pressure with Intra-Abdominal Pressure and Urine Output in Critically III Patients: A Prospective Observational Study. Ulutas Med J. 2026; 12(3): 41-48. doi:10.5455/umj.20260803090348

Web Style

Nureddin Yuzkat. Association of High Positive End-Expiratory Pressure with Intra-Abdominal Pressure and Urine Output in Critically III Patients: A Prospective Observational Study. https://www.ulutasmedicaljournal.com/?mno=330036 [Access: October 06, 2026]. doi:10.5455/umj.20260803090348

AMA (American Medical Association) Style

Nureddin Yuzkat. Association of High Positive End-Expiratory Pressure with Intra-Abdominal Pressure and Urine Output in Critically III Patients: A Prospective Observational Study. Ulutas Med J. 2026; 12(3): 41-48. doi:10.5455/umj.20260803090348


Vancouver/ICMJE Style

Nureddin Yuzkat. Association of High Positive End-Expiratory Pressure with Intra-Abdominal Pressure and Urine Output in Critically III Patients: A Prospective Observational Study. Ulutas Med J. (2026), [cited October 06, 2026]; 12(3): 41-48. doi:10.5455/umj.20260803090348


Harvard Style

Nureddin Yuzkat (2026) Association of High Positive End-Expiratory Pressure with Intra-Abdominal Pressure and Urine Output in Critically III Patients: A Prospective Observational Study. Ulutas Med J, 12 (3), 41-48. doi:10.5455/umj.20260803090348


Turabian Style

Nureddin Yuzkat. 2026. Association of High Positive End-Expiratory Pressure with Intra-Abdominal Pressure and Urine Output in Critically III Patients: A Prospective Observational Study. THE ULUTAS MEDICAL JOURNAL, 12 (3), 41-48. doi:10.5455/umj.20260803090348


Chicago Style

Nureddin Yuzkat. "Association of High Positive End-Expiratory Pressure with Intra-Abdominal Pressure and Urine Output in Critically III Patients: A Prospective Observational Study." THE ULUTAS MEDICAL JOURNAL 12 (2026), 41-48. doi:10.5455/umj.20260803090348


MLA (The Modern Language Association) Style

Nureddin Yuzkat. "Association of High Positive End-Expiratory Pressure with Intra-Abdominal Pressure and Urine Output in Critically III Patients: A Prospective Observational Study." THE ULUTAS MEDICAL JOURNAL 12.3 (2026), 41-48. Print. doi:10.5455/umj.20260803090348


APA (American Psychological Association) Style

Nureddin Yuzkat (2026) Association of High Positive End-Expiratory Pressure with Intra-Abdominal Pressure and Urine Output in Critically III Patients: A Prospective Observational Study. THE ULUTAS MEDICAL JOURNAL, 12 (3), 41-48. doi:10.5455/umj.20260803090348


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