ECMO patients were ventilated with protective parameters, and respiratory rate and ECMO flow were adjusted to achieve normocarbia and oxygen saturation above 92%. assayed on pharyngeal swab, subglottic aspiration and bronchoalveolar lavage in accordance with published guidelines [7] . Bronchoalveolar specimens were obtained with a mini-invasive system (Kimberly-Clark BAL Cath, Kimberly-Klark N.V. Zaventem -Belgium), or by bronchoscopy.