Stress ulcer prophylaxis (SUP) is commonly used in ICU patients to prevent GI bleeding caused by mucosal ischemia (PMID 35777844). The main indications for SUP include: - Mechanical ventilation > 48 hours - Coagulopathy (INR > 1.5, platelets < 50K) - Severe burns (> 35% BSA) - TBI/SCI - Sepsis/shock states - Hx of GIB or PUD within one year - High-dose corticosteroids - Multisystem organ failure Consider the indication before reflexively starting a PPI/H2 blocker on ICU patients. 🙏 MedThreads