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The stimulating Editorial by Datzmann et al . (1) suggests further considerations on the prognostic parameters for patients on veno venous extracorporeal membrane oxygenation (VV ECMO) support. While VV ECMO is increasingly acknowledged as a life-saving therapeutic tool for refractory acute respiratory distress syndrome (ARDS) especially in high volume and experienced centers, it is also is associated with elevated costs, resource, and complications (2) and appropriate risk stratication of candidate patients is necessary to recognize those more likely to benet from VV ECMO (3). Moreover, in everyday practice, an objective risk assessment for refractory ARDS on ECMO support is a clinical need for intensivists also to provide relatives with information about the patient’s condition.

Risk stratification for severe acute respiratory distress syndrome requiring veno venous extracorporeal membrane oxygenation: a clinical need