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From early May 2009,the novel influenza A (H1N1) pandemic affected mainland China.Of those infected,a small proportion of patients developed acute respiratory distress syndrome CARDS) so rapidly and severely that conventional ventilation treatment was ineffective.As an alternative treatment,the effect of extracorporeal membrane oxygenation (ECMO) was evaluated.From November 2009 to January 2010,all patients suffering from influenza A (H1N1)associated ARDS referred to Beijing Anzhen Hospital for treatment with ECMO were enrolled.We describe the characteristics,treatment,and outcomes of these patients at land 3month followup.Nine patients (four females; mean age,31.2 [21-59] years) from four centers were enrolled.All females had a history of recent pregnancy or had recently given birth.Before ECMO,patients had severe respiratory failure despite advanced mechanical ventilatory support with a mean partial pressure of arterial oxygen/fraction of inspired oxygen of 52.9 1 5.1 (45.0-63.8) mm Hg,positive endexpiratory pressure of 17.2 ± 4.2 cmH}O,and a Murray Lung Score of 3.6 (3.25-3.75).All nine patients were treated with venovenous ECMO via percutaneous access.The mean duration of ECMO support was 436.6 ± 652.1 h (67.0-2160.0).At the end of 3month follow—up,five patients (55.7%) were weaned from ECMO.