The ECLS team consists of an intensivist, a cardiac surgeon, a cardiologist and a perfusionist, all trained on ECLS technique and management. According to our activation protocol, ECLS team can be summoned within one hour, with 24 hour coverage. In most cases, the intensivist primes the process on the basis of clinical and radiological findings and activates the full ECLS team. The cardiologist's main task is to evaluate cardiac function in the pre-ECLS phase and guides the correct positioning of ECLS cannulas by transesophageal ultrasonography. Furthermore, the cardiologist is directly involved in selecting patients with cardiac failure suitable for ECLS treatment. The cardiac surgeon, in addition to actively participating to the clinical decision making process, is responsible for selecting and inserting the cannulas and starting the extracorporeal circulation, with the assistance of the perfusionist. In case of an ECLS run, irrespectively of the unit where the patient was admitted (General or Cardiac ICU), all the professionals of the team were available for consultation and performed at least one daily evaluation. This study, supported by institutional funds only, followed the principles of the Helsinki declaration and was approved by the Internal Review Board. Informed consent for data publication was obtained.