RecruitingInterventional

Timing of nutrition in emergency laparotomy

The TONIC study investigates whether starting special liquid food directly into a vein (called parenteral nutrition) early can help adults recover better after urgent belly surgery. When people have emergency abdominal surgery, they might not be able to eat normally for some time. This study wants to find out if giving this special nourishment within the first two days after surgery reduces complications and improves recovery in the hospital, compared to waiting until later if needed. It's important because good nutrition is key to getting well, but doctors are not sure about the best timing for this type of feeding. The study involves monitoring participants' recovery, complications, length of hospital stay, and quality of life.

At a glance

Status

Recruiting

Sponsor

University of Birmingham

Enrolment target

898

Start

16 Mar 2026

Estimated completion

31 Aug 2027

Hospital complications in adults undergoing emergency laparotomy

What is this study about?

Imagine you or a loved one needs urgent surgery on their tummy. This type of operation is sometimes called an emergency laparotomy or laparoscopy. After such a big operation, it can be hard to eat properly for a while. Good food and nutrients are super important for getting better and healing well.

Doctors sometimes give a special liquid food directly into a vein (like an IV drip) when someone can't eat enough through their mouth or a feeding tube. This is called parenteral nutrition. What doctors aren't sure about is *when* the best time is to start this special feeding after emergency tummy surgery. Should it be given very soon after the operation, or is it okay to wait a few days?

This study, called TONIC, aims to answer that question. It wants to see if starting this special feeding within the first two days after surgery helps people have fewer problems in hospital and recover better, compared to the usual approach where this type of feeding might be introduced later if it's really needed. By finding this out, the study hopes to improve care for people having emergency tummy surgery in the future.

Key takeaways

The TONIC study explores the best timing for special vein feeding after urgent tummy surgery.
It compares starting this feeding early (within 2 days) versus usual care.
The aim is to reduce hospital problems and improve recovery for patients.
Participation involves being randomly put into one of two care groups.
You will be closely monitored, and your regular medical care continues as normal.
The study is backed by UK health research funding and aims to improve future patient care.

Who may be eligible?

You might be able to take part in this study if you are an adult, aged 18 or over, and are going to have urgent or emergency surgery on your tummy as part of your normal NHS care.

However, there are some reasons why you wouldn't be able to join. For example, if your surgery is for a major injury like a car crash, or if you are receiving care focused on making you comfortable towards the end of your life. You also can't take part if you've had tummy surgery in the last month, or if you were already receiving long-term special feeding into your vein before you came into hospital.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 years old or older?
Are you having urgent or emergency surgery on your tummy?
Is your surgery NOT for a major injury or accident?
Have you NOT had tummy surgery in the last 30 days?
Are you NOT already getting long-term special feeding into your vein?
Are you NOT receiving care focused on comfort towards the end of life?

Answer every question to see your result.

What does participation involve?

If you decide to take part, you'll be put into one of two groups by chance, like flipping a coin. No one gets to choose which group they are in. One group will start receiving the special liquid food directly into a vein (parenteral nutrition) within two days of their operation. The other group will get the usual care, which might include eating normal food, special drinks, or feeding through a tube if needed. This second group would only get the special feeding into a vein if it becomes necessary, usually after at least five days. The study team will collect information about your recovery, any problems you might have, how long you stay in hospital, and your general well-being. This information will come from your medical records and from some short questionnaires you might fill out up to 90 days after your operation.

Potential risks and benefits

You might or might not directly benefit from taking part in this study. It's possible that getting early special feeding could help some people recover faster with fewer problems, but we don't know for sure yet – that's why the study is being done. The risks involved are similar to the usual care. Sometimes, putting a line into a vein for feeding can lead to issues like infection or irritation where the line goes in. The doctors and nurses looking after you will watch you very closely, and your regular medical care will stay the same whether you take part in the study or not. You are always free to change your mind and leave the study at any time.

Locations (6)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

University Hospitals Birmingham NHS Foundation Trust
City only
Birmingham, England
Sheffield Teaching Hospital
Unverified
Sheffield, United Kingdom
Queen Elizabeth Hospital
Unverified
Birmingham, United Kingdom
Somerset Teaching Hospital
Unverified
Taunton, United Kingdom
Midland Metropolitan
Unverified
Birmingham, United Kingdom
Blackpool Teaching Hospital
Unverified
Blackpool, United Kingdom

Common questions

What is 'parenteral nutrition'?

It's a special liquid food given directly into a patient's vein when they can't eat or digest food normally. It's like an IV drip but carries all the nutrients needed.

What does 'emergency laparotomy' mean?

It's an urgent operation on the tummy (abdomen). This could be for a serious condition like a burst appendix or bleeding inside.

Will I know which group I'm in?

Yes, once you've joined the study, your medical team will know whether you are in the early feeding group or the usual care group.

Who is paying for this study?

The study is funded by a UK government research organisation called the National Institute for Health and Care Research (NIHR).

Can I stop participating in the study if I change my mind?

Yes, absolutely. You can withdraw from the study at any time without it affecting your medical care.

How to find out more

Georgia Mitchell

tonic@trials.bham.ac.uk - Official trial record

Always speak to your GP or specialist before deciding to take part in a study.