Head trauma and severe cerebral hemorrhage are major risk factors for development of ventilator-associated pneumonia. In a previous open labelled, single center study the investigators showed that repeated oropharyngeal decontamination with povidone-iodine may be an effective strategy to decrease the prevalence of ventilator-associated pneumonia in patients with head trauma. The present study aims to confirm these results in a multicenter, double blind study including patients suffering from head trauma or cerebral hemorrhage.

Inclusion Criteria:

• Adults > 18 years
• Closed head trauma with a Glasgow Coma Score <=8 or cerebral Hemorrhage with a Glasgow Coma Score of <=8
• Expected need mechanical ventilation for >=2 days
• Written informed consent from the patient's next-of-kin. If no relative is present at the time of inclusion, the patients will be included according to the emergency procedure

Exclusion Criteria:

• Impossibility to perform oropharyngeal decontamination within 12 h following the initial episode
• Facial injury with impossibility to perform the oropharyngeal decontamination
• Tetraplegia
• Known history of reaction to iodine
• Respiratory disease or pulmonary infiltrate(s) at inclusion
• Need for curative antibiotics
• Mercurial antiseptics treatment
• Pregnancy