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J Indian Assoc Pediatr Surg. 2011 Oct;16(4):129-31. doi: 10.4103/0971-9261.86864.

Intravesical pressure: A new prognostic indicator in congenital diaphragmatic hernia.

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1
Department of Pediatric Surgery and Neonatology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.

Abstract

AIMS:

To evaluate the usefulness of intravesical pressure as a prognostic indicator in congenital diaphragmatic hernia.

MATERIAL AND METHODS:

In 25 cases, bladder pressure was measured intraoperatively during repair.

RESULTS:

Cases were divided into three groups according to the intravesical pressure. Group 1: pressure <10 cm (n.9), Group 2: 10-15 cm (n.11) and Group 3: >15 cm (n.5). Number of ventilated days was tabulated against these groups. Median number of ventilated days for Group 1, with the lowest pressure, was 3 days, while that for Group 2 was 5 and for Group 3, with the highest pressure, was 10 days. This was significant, with a P-value of 0.016.

CONCLUSION:

Measurement of intravesical pressure is a reliable prognostic indicator in newborns with congenital diaphragmatic hernia. It also helps in predicting postoperative ventilatory requirement.

KEYWORDS:

Bladder pressure; congenital diaphragmatic hernia; intra-abdominal pressure; pulmonary hypoplasia

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