Introduction: Breathing is an essential function of every living creature. Premature baby who was born before the lungs could synthesise surfactant could develop respiratory distress sindrome right after they were born. Premature baby with respiratory distress can be helped with numerous ways of artificial ventilation, they have to be monitored and the medical staff should be present at all times and clean the airways. A nurse has an important role in it as endotracheal suction is a common procedure in handling intubated premature infants. Aim:of this thesis is to determinate the role of endotracheal intubation in intubated and mechanically ventilated premature infant. Furthermore, we want to determine what role a nurse plays in endotracheal tube suction and pain. Methods: In the thesis, we used a descriptive method with systematic review of the literature, which was time limited with the time span from 2006 to 2016. We searched for literature in English language in databases such as CINAHL, Medline (PubMed), Medscape and Wiley Online Libary. The key words used were premature baby intubation, premature baby intubation AND endotracheal tube suction AND open and close system suction, nursing premature baby AND open and closed system endotracheal suctioning AND premature pain. We included 25 articles in the analysis. In terms of strenght they were evaluated with the four level scale Eccles, Manson (2001). Results: Long term mechanical ventilation can result in chronic disease, for example bronchopulmonary dysplasia, retinopathy, brain haemorrhage etc. bay applying surfactant we can shorten the invasive support of breathing. Closed system of aspiration is thought to be safer for the premature baby because they are connected to the mechanical ventilator all the time and there is minimal handling. A nurse has a major role in providing medical care of a premature baby. She continuosly controls the baby and the ventilator, makes sure the tube is located properly and it does not occlude in between the aspirations. Discussion and conclusion: As both types of endotracheal aspiration are painful, stresfull and unpleasant for the premature infants a nurse also has to be gentle and have a special feeling for the baby.
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