Guideline / position statementindependent cross-checkfull text checked I-GUT-06 standard review
When abdominal pressure becomes dangerous
Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome.
Overview
Kirkpatrick AW et al.. Intensive Care Med 2013 · PMID 23673399 · DOI 10.1007/s00134-013-2906-z
Harmful pressure starts at ≥12 mmHg sustained, in critically ill patients.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
IAH definitions.
- How was the study done?
Consensus.
- What was actually found?
Thresholds defined.
- How large was the observed effect?
≥12 mmHg; >20 mmHg.
- What do the results mean in everyday life?
Ordinary bloating is not ACS.
- What are the study's limitations?
ICU focus.
- What does it say about Elawady's specific claim?
Contradicts C-GUT-04.
- Do the results apply to Germany and Europe?
Applicable.
- What can explicitly not be concluded from this study?
Normal post-meal values.
Scientific in-depth review
1. Full reference
- Authors
- Kirkpatrick AW et al.
- Journal
- Intensive Care Med
- Year
- 2013
- Identifier
- PMID 23673399 DOI 10.1007/s00134-013-2906-z
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- full text
- Conflicts of interest and funding
not stated in abstract
2. Research question
Definitions and management of intra-abdominal hypertension and abdominal compartment syndrome
3. Study design and population
- Study design
- Guideline / position statement – Consensus definitions and clinical practice guidelines (WSACS), GRADE
- Population
Critically ill patients
- Country
International
- Period
2013
4. Methods and endpoints
- Endpoints
Definitions; recommendations
- Statistical methods
Modified Delphi; GRADE
5. Actual results
- Results
Full text: IAP is approximately 5–7 mmHg in critically ill adults; IAH is a sustained or repeated pathological IAP ≥12 mmHg; ACS is sustained IAP >20 mmHg with new organ dysfunction; grades I–IV (12–15, 16–20, 21–25, >25 mmHg).
- Absolute risks
not applicable
- Authors' conclusion
IAH/ACS are common in critical illness; evidence quality generally low.
6. Strengths
- International consensus
7. Weaknesses
- Low-quality evidence base
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Consensus.
9. Assessment of the statistical interpretation
10. Relevance to the specific claim
11. Independent contrary findings
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Defines thresholds far above ordinary bloating.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | indirect |
| Reproducibility | unknown |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Post-meal IAP in healthy people not covered.
15. Linked fact checks
- Bloating after meals raises intra-abdominal pressure enough to compress the aorta and inferior vena cava and to reduce blood flow to the organs. – Studies contradicting or limiting the claim
- Instant noodles ('Indomie') and processed foods cause sudden spikes in intra-abdominal pressure and serious problems such as intestinal obstruction. – Studies contradicting or limiting the claim