In recent years, pumpless arteriovenous systems for extracorporeal gas exchange have become a new therapeutic option for the treatment of patients suffering from acute respiratory failure. Experiences with the pumpless extracorporeal membrane lung in animal experiments and in patients with adult respiratory distress syndrome published in the current literature are reviewed. In addition this article presents a case of varicella pneumonia with persistent hypoxemia and hypercapnia under mechanical ventilation that showed a significant improvement with treatment with a pumpless extracorporeal lung assist using an arteriovenous shunt for eight days. The patient made a complete recovery. This is the first report of a patient with a life-threatening varicella pneumonia successfully treated with pumpless extracorporeal lung assist device. This review provides an update on interventional lung assist devices and a critical discussion of their advantages and limitations.