Der Anaesthesist
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Nosocomial pneumonia is a major risk for long term ventilated ICU patients. The infection route may be hematogenic or via inhalation or aspiration of microorganisms. The source of aspiration is the oropharynx. ⋯ During enteral nutrition, 31,4% of the aspirates were sterile, whereas during parenteral nutrition only 24,3% of the gastric aspirates were sterile. Therefore, enteral nutrition should be started as soon as possible, the pH-value should be checked frequently and should not exceed 4 in order to reduce bacterial overgrowth in the stomach. A further consequence is to use as few antibiotics as possible.