Veno-venous extracorporeal membrane oxygenation (VV-ECMO) supportive therapy improves outcomes and reduces mortality for patients with acute respiratory distress syndrome. VV-ECMO, however, also increases the need for RBC transfusions, especially after decannulation of the large cannulae from major veins and removal of circuit tubing containing 500 to 700 mL of the patient’s blood. Some centers utilize blood cell salvage systems (BCS)…