Introduction: Usage of extracorporeal membrane oxygenation (ECMO) in the trauma population has been reported to have a mortality benefit in patients with severe refractory hypoxic respiratory failure. This study compares the early initiation of ECMO for management of severe Acute Respiratory Distress Syndrome (ARDS) versus a historical control immediately preceding the use of ECMO for trauma patients. Methods: A retrospective study was conducted at a single verified Level I trauma center. The study population was limited to trauma patients diagnosed with severe ARDS using the Berlin definition (PaO2/FiO2 [P/F] ratio
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