Conclusion
We classically learned at medical school that survival is impossible with pH<7 but this dogma seems, in very selected cases, challenged considering the rapid development of ECMO programs. Although survival is possible with an extremely low pH in ECMO patients, it remains rare. A strong correlation between pH and lactate level as prognosis factors leads to integrate such parameters to build a new score to help in the decision-making process of ECMO cannulation. We observed a survival rate lower than 7% when pH was lower than 7 and lactates level more than 7. We believe such simple easy reminder rule might be useful waiting for a better and more appropriate survival score in this very severe population.