| Design | Multicentre placebo-controlled RCT, n=3,298 (SUP-ICU) |
| Published | 2018 (NEJM) |
| Result | No significant difference in 90-day mortality between pantoprazole and placebo (31.1% vs 30.4%). Clinically important GI bleeding was lower with pantoprazole (2.5% vs 4.2%). |
| Practice impact | Does not support routine PPI prophylaxis for all ICU patients; risk-benefit should be individualised based on bleeding risk. |
Source: The Bottom Line