Modified Mapleson D system for long-term mechanical ventilation of infants and children

The Bain circuit, a modified Mapleson D system, is a lightweight, simple circuit which has been used primarily for anesthesia. This report describes its use for long-term mechanical ventilation for infants and children. The use of this circuit improved warming of inspired gas reducing patient heat loss and, additionally, it was believed to have resulted in increased humidity of the inspired gas. There were no instances of accidental extubation nor were any of the endotracheal tubes blocked by inspissated secretions. Temperatures of the humidifiers had to be lower than conventionally recommended but this did not result in any nosocomial infections. This circuit is an effective and safe circuit to use for long-term mechanical ventilation of children.