title: [Can increased intra-abdominal pressure (IAP) be treated more effectively with intravesical pressure measurement in high-risk patients?].
abstract: BACKGROUND
  Increased intra-abdominal pressure (IAP) can result in multiorgan failure. Trauma, mechanical bowel obstruction (MBO), abdominal wall defects (AWD) and fluid resuscitation in septic shock are conditions associated with a high risk of increased IAP in children. It may be possible to treat these conditions more effectively using intravesical pressure measurement.
  
  
  METHODS
  This prospective study was performed between December 2009 and October 2010. Intravesical pressure (IVP) measurement was used to determine IAP. The presence of Intra-abdominal hypertension (IAP >12 mmHg) and abdominal compartment syndrome (IAP >15 mmHg + new organ dysfunction) was evaluated in all clinical decisions.
  
  
  RESULTS
  IVP monitoring was applied in all patients with abdominal trauma (14), AWD (8), fluid resuscitation for septic shock (7), and MBO (6). A diagnosis of ACS was determined in 14% of trauma patients and required surgery. IAH/ACS occurred in 38% of AWD cases, which required closure. IAH occurred in 43% of patients undergoing fluid resuscitation for septic shock, requiring decompressive intervention. IAH/ACS occurred in 50 % of MBO patients, all of whom required surgery.
  
  
  CONCLUSIONS
  IVP measurement is a useful method to identify candidates for surgical treatment in cases of trauma and MBO. Similarly, IVP monitoring can facilitate the closure of abdominal wall defects and the application of fluid resuscitation in septic shock.
authors.affiliation: Department of Pediatric Surgery, Ege University Faculty of Medicine, İzmir, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Divarcı
authors.affiliation: Department of Pediatric Surgery, Ege University Faculty of Medicine, İzmir, Turkey.
authors.forename: Orkan
authors.initials: O
authors.lastname: Ergün
authors.affiliation: Department of Pediatrics, Intensive Care Unit, Ege University Faculty of Medicine, İzmir, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Karapınar
authors.affiliation: Department of Pediatrics, Division of Neonatology, Ege University Faculty of Medicine, İzmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yalaz
authors.affiliation: Department of Pediatric Surgery, Ege University Faculty of Medicine, İzmir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Celik
mesh_terms: D034841:Abdominal Cavity / Q000503:physiopathology*; D000007:Abdominal Injuries / Q000503:physiopathology* / Q000628:therapy; D000293:Adolescent; D002648:Child; D003161:Compartment Syndromes / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008991:Monitoring, Physiologic; D056888:Patient Positioning; D011446:Prospective Studies; D001743:Urinary Bladder / Q000503:physiopathology