Don’t forget ECMO in ARDS: CESAR trial

Previous studies suggested no improvement in outcomes for ARDS treated with extracorporeal membrane oxygenation (ECMO). i thought ECMO is not used any more!
CESAR trial presented in the Society of Critical Care Medicine 37th Critical Care Congress suggests it should be considered early in certain patients.
Most patients with ARDS die due to their underlying disease.Those who appear at risk of dying of respiratory failure may be worthy of consideration for ECMO.
The investigators used a Murray score of 3 or more as a criterion for patient selection.
The Murray Score calculator is here. It remains to be seen how it should be incorporated into clinical practice, especially we who dont have ECMO. Should patients be shipped?