A nonoccluding bag and closed scavenging system for the Jackson Rees modified T-piece breathing system

We used the inner tube and its 22-mm connector from the patient end of a Bain breathing system to splint the double-ended bag of the Jackson Rees modification of the Ayre's T-piece breathing system. A paediatric airway pressure-limiting valve was connected to the distal end of the tube for closed scavenging. The resistance of the modified bags was similar to that of unmodified bags at gas flows below 11 l.min-1. The valve offered no resistance to gas flows below 5 l.min-1. During its use in 30 paediatric patients, analysis of carbon dioxide from inside the bag and from the expiratory port confirmed no loss of deadspace gas by preferential flow bypassing the bag into the scavenging system.