Optimal Positive End-Expiratory Pressure During Pumpless Extracorporeal Lung Membrane Support

The aim of this study was to determine the optimal positive end-expiratory pressure (PEEP) required during extracorporeal lung membrane support (interventional lung assist [iLA]; Novalung GmbH, Hechingen, Germany). Twenty healthy pigs were initially (4 h) mechanically ventilated with a tidal volume (V(T)) of 10 mL/Kg, respiratory rate (RR) of 20 breaths/min, PEEP of 5 cm H(2)O, and fraction of inspired O(2) (FiO(2)) of 1.0. Thereafter, the iLAs were placed arteriovenously transfemorally and settings reduced to reach near static ventilation (V(T) 12 cm H(2)O, and this without hemodynamical imbalance. This study suggests that the iLA may provide adequate gas exchange during static ventilation only with PEEP levels > 10 cm H(2)O, and this without pulmonary or systemic hemodynamic imbalance.