ECMO as rescue for COVID-19 related ARDS: the pros and cons

Using extracorporeal membrane oxygenation (ECMO) as rescue respiratory support for COVID-19 related ARDS may be seen as a controversial use of scarce and stretched resources in the context of a global pandemic. We present two cases of COVID-19 related ARDS both requiring ECMO support in an experienced ECMO tertiary centre. The cases illustrate the decision-making concerning the initiation of ECMO during life-threatening COVID-19 related respiratory failure. Both patients encountered the typical complications during extensive ECMO support, but with a completely different outcome. To identify patients that really benefit from this potentially life-saving support modality and attain meaningful functional outcome in addition to survival, remains a matter of debate.