Historical vignette – The Mapleson G, an original pediatric anesthesia circuit


Anesthesiology/instrumentation, pediatrics, pulmonary ventilation, Mapleson

Published online: Dec 03 2022


B.F. Gribomont1, B. Le Polain de Waroux1, F.A. Veyckemans2, B.K. Ki3, Y.B. Kabre3, R.C. Neighbour4, P.l. Baele1

1 Professor Emeritus, Anesthesiology, UCLouvain, Belgium. Cliniques Universitaires Saint-Luc, 10 avenue Hippocrate, 1200 Brussels, Belgium
2 Clinique d’Anesthésie pédiatrique, Hôpital Jeanne de Flandre, CHU de Lille, Avenue O. Lambret 2, 59037 Lille, France
3 Faculty of Medicine, Ki Zerbo University; Anesthesiology and Intensive Care department, Pediatric Academic Hospital Charles De Gaulle, Ouagadougou, Burkina Faso, West Africa
4 Diamedica UK Ltd, Grange Hill Ind Est, Bratton Fleming, Devon EX31 4UH, United Kingdom


A previously unpublished pediatric anesthesia circuit is presented here.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.