National survey of pediatric breathing systems use in the UK*

Abstract

To determine current practice in the use of pediatric breathing systems in the UK. Whilst the Ayres T-Piece has been used extensively in pediatric anesthesia for nearly six decades, the circle system has undergone recent modifications. These have enhanced its suitability for pediatric use. A postal questionnaire was sent to all consultant members of the Association of Paediatric Anaesthetists (APA). This asked about standard breathing systems for induction, maintenance, and ventilation during anesthesia in three groups of children (neonates, infants, and older children less than 20 kg). Additional questions included if anesthetic rooms were used and scavenging routinely employed. Replies were received from 337 members, giving a response rate of 75%. The T-Piece was the predominant breathing system for induction in all age groups but the circle appears popular for maintenance, particularly in older children. Anesthetic rooms were used by 97% for induction and scavenging used by only 60% when using a T-Piece. Despite significant improvements to the pediatric circle system and its practical advantages, the T-Piece remains the commonest breathing system used in smaller children by UK members of the APA.