Inclusion Criteria:  Age of 18 years or more; Mechanical ventilation more than 24 hours; Expected length of mechanical ventialtion more than 72 hours;  Exclusion Criteria:  Aspiration at the prehospital stage Community-acquired pneumonia COPD or specific lung diseases Сhest Injury Hemo and \or pneumothorax Fat embolism Lung cancer Severe renal and\or hepatic impairment Blood platelets less than 50 000 / μl Pregnancy and the period of breastfeeding; Other circumstances that the researcher considers inappropriate to participate in this study