Duffett M, Chan A, Closs J, et al. - Researchers conducted a multicenter cohort study to depict current stress ulcer prophylaxis practice in Canadian PICUs. Stress ulcer prophylaxis was defined as the use of a proton-pump inhibitor, histamine-2 receptor antagonist, or sucralfate within the first 2 PICU days among children who had not been on these medications at home and had no evidence of gastrointestinal bleeding. From seven PICUs they assessed 378 children requiring mechanical ventilation. Children were ventilated for a median (interquartile range) of 2 days (1–6 d) and stayed in the PICU for a median (interquartile range) of 4 days (2–10 d). A common use of stress ulcer prophylaxis was reported in Canadian PICUs. Acid suppression was provided to 70% of all children during their PICU stay. The most frequently used class was histamine-2 receptor antagonists (66%), followed by proton-pump inhibitors (47%) and sucralfate (4%), and there were 20% who received more than one class. Multivariate analysis revealed an independent association of age and invasive mechanical ventilation with an increased likelihood of receiving stress ulcer prophylaxis and independent association of receiving feeds with a decreased likelihood of receiving stress ulcer prophylaxis. They identified a rare occurrence of clinically important gastrointestinal bleeding and C. difficile–associated diarrhea.