Objective: This study summarizes retrospectively collected data of an institutional experience with venovenous-extracorporeal membrane oxygenation (VV-ECMO) in severe respiratory failure. We also evaluated to identify clinical, hemodynamic, and ventilator parameters associated with successful VV-ECMO removal. Methods: From March 2011 to March 2013, 30 cases of VV-ECMO were performed. After excluding six cases of perioperative use of ECMO, we analyzed 24 cases of VV-ECMO for acute severe respiratory failure. Results: Among the 24 cases who received ECMO for pneumonia (n=11), Exacerbation of ILD or AIP (n=6), or ARDS secondary to sepsis (n=4), aspiration pneumonitis (n=2), and postoperative ARDS (n=1), 14 (58.3%) had successfully weaned from ECMO. In hospital survival rate was 20.8% and mean duration of ECMO was 11.2±10.2 days. In univariate analysis, mean platelet count (×103/μl) of initial admission day (199.4±130.8 vs. 99.0±61.4), pre-ECMO day 1 (200.5±134.6 vs. 80.6±42.8), and post-ECMO day 1 (144.1±80.6 vs. 83.5±28.4) were significantly higher in ECMO weaning group than those values of non-weaning group (p=0.022, 0.013, and 0.034). However, age, BMI, initial SOFA score, duration of mechanical ventilation before ECMO and the degree of hypoxia were not significantly different. Conclusion: The weaning of ECMO was related to platelet counts of ICU admission, pre ECMO and post ECMO day 1. Further studies are needed to evaluate the proper target of PLT level for ECMO.Objective: This study summarizes retrospectively collected data of an institutional experience with venovenous-extracorporeal membrane oxygenation (VV-ECMO) in severe respiratory failure. We also evaluated to identify clinical, hemodynamic, and ventilator parameters associated with successful VV-ECMO removal. Methods: From March 2011 to March 2013, 30 cases of VV-ECMO were performed. After excluding six cases of perioperative use of ECMO, we analyzed 24 cases of VV-ECMO for acute severe respiratory failure. Results: Among the 24 cases who received ECMO for pneumonia (n=11), Exacerbation of ILD or AIP (n=6), or ARDS secondary to sepsis (n=4), aspiration pneumonitis (n=2), and postoperative ARDS (n=1), 14 (58.3%) had successfully weaned from ECMO. In hospital survival rate was 20.8% and mean duration of ECMO was 11.2±10.2 days. In univariate analysis, mean platelet count (×103/μl) of initial admission day (199.4±130.8 vs. 99.0±61.4), pre-ECMO day 1 (200.5±134.6 vs. 80.6±42.8), and post-ECMO day 1 (144.1±80.6 vs. 83.5±28.4) were significantly higher in ECMO weaning group than those values of non-weaning group (p=0.022, 0.013, and 0.034). However, age, BMI, initial SOFA score, duration of mechanical ventilation before ECMO and the degree of hypoxia were not significantly different. Conclusion: The weaning of ECMO was related to platelet counts of ICU admission, pre ECMO and post ECMO day 1. Further studies are needed to evaluate the proper target of PLT level for ECMO.