Critically ill patients are at risk of stress-related mucosal erosions. These are typically superficial and asymptomatic but may progress to ulceration and overt and clinically important gastrointestinal (GI) bleeding, a serious condition associated with increased morbidity and mortality. The balance between benefits and harms of UP is unknown. On the one hand it may very well be that SUP reduces the risk of GI bleeding; on the other hand, however, SUP may increase the risk of nosocomial infections and other serious adverse events.

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