Venovenous extracorporeal membrane oxygenation (vv-ECMO) is increasingly being used to support patients with severe acute respiratory distress syndrome (ARDS), but its cost-effectiveness is unknown. The cost-utility of vv-ECMO for severe ARDS was assessed in adults compared with standard lung protective ventilation from the perspective of the healthcare system. According to current data, vv-ECMO is cost-effective for patients with severe ARDS. Additional evidence on the efficacy of vv-ECMO for ARDS and in different subgroups of patients will allow for greater certainty in its cost-effectiveness. The use of vv-ECMO compared with lung protective ventilation resulted in a gain of 5.2 life years at an additional lifetime cost of $145,697 Canadian dollars.

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