Oh, joy! Another paper telling us that extracorporeal membrane oxygenation (ECMO) is the knight in shining armor for those with acute respiratory distress syndrome (ARDS). Because, you know, we hadn’t figured out that ECMO might be useful after seeing it in action for only, what, a few decades now? The paper sets out on a noble quest to enlighten us about ECMO’s physiology, its various configurations for ARDS patients, and to bravely review evidence that—hold your applause—supports ECMO’s use in ARDS. Groundbreaking!

But wait, there’s more! It turns out, combining ECMO with what they call an “ultra-lung-protective approach” to mechanical ventilation is like peanut butter and jelly for patients with ARDS who are giving the silent treatment to traditional oxygen therapy. Who would’ve thought that refractory hypoxemia or hypercapnia with severe respiratory acidosis could be managed with something as fancy as ECMO? And here’s a shocker: the more you use it, the better you get. Apparently, center volume and experience matter. It’s almost as if practice makes perfect or something equally revelatory.

But don’t get too excited. The paper also hints that we’re still fumbling in the dark when it comes to using these extracorporeal technologies in expanded patient populations and figuring out the best way to manage patients while they’re hooked up to these life-saving machines. So, in essence, while we’ve been patting ourselves on the back for finally getting on the ECMO bandwagon for ARDS, there’s a whole lot we still don’t know. But fear not, this article is freely available, because knowledge like this just can’t be contained.