Introduction: Acute respiratory failure is a life-threatening condition in children. It is defined as the inability to provide oxygen to the body and to remove carbon dioxide from the body at the rate that corresponds to metabolic requirements of an organism. The disorder may occur due to failure of the respiratory centre, impairment of respiratory muscles as well as impaired ventilation and pulmonary perfusion. There are two types of respiratory failure: hypoxemic, where the primary reason for hypoxia lies in the air sac impairment, and hypercapnic, which is the result of respiratory pump failure, unable to adequately exchange gases. Purpose: The aim of the paper is to present the particularities of a child's respiratory system, describe the characteristics of acute respiratory failure and outline different mechanical ventilation methods and the role of a nurse in performing aspiration. Methods: In the paper, a descriptive research method was used, along with a systematic review and analysis of academic and scientific literature. The literature was found in the MEDLINE, PubMed, ScienceDirect and Google Scholar databases as well as the PubMed and DiKUL search engines. The articles included in the research are written in Slovene and English, and they could be accessed in entirety. Scientific literature was also obtained by searching in the library of the Faculty of Health Sciences and the Faculty of Medicine from May to July 2020. Results: Mechanical ventilation saves children's lives as it reduces a child's breathing efforts and alleviates their breathing. A child can undergo two types of mechanical ventilations: invasive and non-invasive. Compared to the non-invasive mechanical ventilation, invasive mechanical ventilation requires an artificial respiratory tract. Based on a child's active breathing capability, breathing support can be full or partial. When these methods do not answer a child's needs, doctors may opt to establish extracorporeal circulation or to carry out high-frequency oscillatory ventilation. Children with breathing failure often require aspirations. The role of a nurse is to ensure airflow patency. Aspiration can be performed through the nose or mouth and through endotracheal tubes or a cannula. Discussion and conclusion: Mechanical ventilation is essential in treating respiratory failure. A child undergoing mechanical ventilation is treated in the intensive care unit, where a nurse constantly monitors their vital signs and behaviour. A nurse must possess specific knowledge and be well-familiar with a healthy child's physiology to identify pathological changes. They must also be familiar with the ventilator's functioning, types and methods of mechanical ventilation, basic phases of a respiratory cycle, reasons to sound the alarm and the impacts of mechanical ventilation on a child's physiology and possible complications.
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