In our population bleeding also occurred more frequently in ECMO patients, and they required more transfusions compared to non ECMO patients. Nevertheless, in our experience, bleeding from cannulas insertion site or from upper airways, despite requiring transfusion, were not life threatening, and could be managed. In only two cases did severe bleeding occur in the lower respiratory tract. Fortunately in one case it occurred during weaning from ECMO, and it ceased after extracorporeal support removal. The other patient died from pulmonary aspergillosis and the haemorrhage could be also related to parenchyma disruption caused by the fungus.