Since the 1970s, ECMO or extracorporeal membrane oxygenation has become an accepted treatment for severe respiratory distress in neonates. The use of ECMO in adult patients, however, has been more controversial with only 42 centers offering adult ECMO worldwide. Interest in adult ECMO has enjoyed a renaissance with the CESAR trial and H1N1 pandemic flu epidemic. This workshop will describe the technical aspects of ECMO including advances in oxygenators, patient selection criteria for adult ECMO, blood product utilization and recent clinical outcome data and trials, particularly in the aftermath of the recent H1N1 flu pandemic.