A previously unpublished pediatric anesthesia circuit is presented here. It was invented and constructed by Dr
Bernard-François Gribomont (hence called BFG circuit) around 1965 as a response to the important pediatric
case load in the university hospital of Lovanium, near Leopoldville (now Kinshasa, DRC). The original objective
was to find a simple solution that would enable the manual ventilation (assisted or controlled) of young children
during ENT surgery, remaining very close to the child to reduce dead space while at the same time keeping far
enough away from the surgeon in order to avoid obstructing their work.
It includes a short coaxial single piece circuit devoid of any mechanical valve connected to an in-line fresh gas
ventilation bag; it does not fit into any existing Mapleson category. Hence, the authors propose to classify it in
a new Mapleson G class. Its main advantages are conceptual simplicity, inherent safety, very low dead space
accounting for minimal rebreathing and thus reduced fresh gas flow, small size and weight, and ease of use even
during prolonged manual ventilation in small children. Its main drawback is difficult scavenging of expired
gases. For logistical reasons it was abandoned in the nineties but could be of renewed interest in low-income
countries.
Anesthesiology/instrumentation, pediatrics, pulmonary ventilation