In the midst of the 2009 influenza A H1N1 pandemic, clinicians turned to extracorporeal membrane oxygenation (ECMO) as a strategy to save lives.

Based on the H1N1 experience, and the ECMO to Rescue Lung Injury in Severe Acute Respiratory Distress Syndrome (EOLIA) trial, ECMO capability has increased exponentially over the past decade, including the growth of mobile ECMO programs designed to increase access to the technology and provide care in experienced centers.

Despite its potential to save lives, the National Institutes of Health COVID-19 treatment guidelines concluded “there are insufficient data to recommend either for or against the routine use of ECMO for patients with COVID-19 and refractory hypoxemia”.

The study by Yang et al is an important early contribution to our understanding of the role of ECMO in the COVID-19 pandemic.

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