Granda MJP, et al. - This study was designed to evaluate the efficacy of selective digestive decontamination (SDD) without parenteral antibiotics for preventing ventilator-associated pneumonia (VAP) in a major heart surgery (MHS) Intensive Care Unit. Observations revealed that in high-risk patients, SDD without parenteral antibiotics could lead to reduced incidence of VAP after MHS, with no significant ecological impact.