Should the use of modified Jackson Rees T‐piece breathing system be abandoned in preschool children?

Abstract

The efficacy of bag and mask ventilation was highly dependent on the training of the anesthesiologist with consultants demonstrating significantly better skills than any of the other groups. As the circle system is associated with a much steeper learning curve than the Jackson Rees system, its use in daily routine practice may prevent ventilatory impairment induced by gastric insufflation.

National survey of pediatric breathing systems use in the UK*

“…One of the authors (DM) recently worked in a major teaching centre in Australasia (Starship Childrens’ Hospital, Auckland, New Zealand) where circle systems are now used exclusively for anesthesia in children of all ages. Following this experience and after several recent publications describing the benefits of the circle system in pediatric anesthetic practice (3,4), the authors noted that there is no current estimation of breathing systems use in smaller children in the UK. The aim of this study was to gather information about the use of pediatric breathing systems nationally.…”

Prone equals prone? Impact of positioning techniques on respiratory function in anesthetized and paralyzed healthy children

“…However, a wide range of interindividual FRC values was a regular finding in all studies of our group in anesthetized preschool children when using the SF6 multibreath washout technique, independent of the method of breathing (spontaneous versus mechanical ventilation), the anesthetic agent used (propofol versus ketamine), body positioning (supine, prone, lateral), the use of regional techniques or even before and after cardiac bypass [34,[43][44][45][46][47]. Although absolute values vary among the patients, the relative changes between the different assessments show a lower variability.…”

Impact of anaesthesia on lung function in children

“…The results of our study show that efficacy of bag and mask ventilation is highly dependent on the training of the anaesthetist in charge of ventilation [2]. The breathing system plays a crucial role in preventing ventilatory impairment as a result of gastric insufflation.…”