Persistent hypoxemia during veno-venous extracorporeal membrane oxygenation (VV-ECMO) for supporting acute respiratory distress syndrome (ARDS) patients is a clinical challenge for intensive care medical providers.

Prone positioning is an effective strategy to treat persistent hypoxemia; however, placing a patient in a prone position is resource intensive with significant risks to the patient.

We present a patient with severe ARDS receiving VV-ECMO who underwent verticalization therapy and subsequently recovered pulmonary function.

Managing refractory tissue hypoxemia during VV-ECMO therapy for ARDS patients is a clinical challenge for intensive care physicians. Previously reported proposed changes in patient positioning, such as PP, are effective yet logistically challenging and associated with risks and complications.

VT is potentially an effective yet technically less demanding alternative to PP in the setting of VV-ECMO for ARDS patients.

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