In intensive care, many gastric tubes are inserted on a regular basis. There are different practices in terms of the location of the gastric tube. In some cases, the tube is inserted through the nose and in others, it is inserted through the mouth.

In the literature and in practice, these gastric tubes create discomfort and complications that have an impact not only on the patient, but also on the treatments and the length of the patient's stay in hospital.

Nosocomial Ventilator Associated Pneumonia is the most serious common complication for patients intubated with a gastric tube. It is possible that placement site may have an impact on the risk of developing Ventilator Associated Pneumonia, particularly by increasing the risk of bacterial pullulation opposite the sinuses when the tube is placed via the nasal route.

Investigator hypothesises that placing the gastric tube orally will reduce the rate of ventilator-associated pneumonia compared with the nasal route in mechanically ventilated intensive care patients.

Inclusion Criteria:

• patient in intensive care, intubated, ventilated
• Adult
• Requiring a gastric tube
• With an expected duration of mechanical ventilation of more than 48 hours
• Affiliated to social security
• Patient or relative consent or, failing that, emergency inclusion of the patient

Exclusion Criteria:

• Pregnant, breast-feeding or parturient women
• Patients under legal protection: curatorship and guardianship
• Contraindication to placing a gastric tube through the nose or mouth
• Patients who already have a gastric tube when they enter the service
• Patient intubated for more than 24 hours
• Patient intubated via the nasotracheal route