Objectives: To explore technique and monitor of intrabladder pressure (IBP) in prolonged Dengue shock syndrome (DSS) complicated with acute respiratory failure due to abdominal ascites. Design: Prospective case series study. Main results: 54 prolonged DDS children complicated with acute respiratory failure due to abdominal ascites who were determined by MacELISA positive for Dengue, indicated intrabladder pressure (IBP) monitor, consisted of DSS (grade III) (77.8%), severe DSS (grade IV) (22.2%), mean age 6.6 years old, youngest age of 3 years.