Intra-abdominal hypertension (IAH) is defined as a repeated or sustained intra-abdominal pressure (IAP) above or equal to 12 mm Hg, and abdominal compartment syndrome (ACS) is defined as a sustained IAP above 20 mm Hg associated with new organ dysfunction or failure [1].A previous case report described how noninvasive ventilation (NIV) caused aerophagia, gastric distension and increased IAP, culminating in ACS and cardio-respiratory arrest. Resuscitative efforts included gastric decompression with a nasogastric tube, which resulted in instant clinical