This part, we'll talk about the VV-ECMO for lung support, and for example, in severe flu patients and currently COVID-19 pandemic. In 2009, there was swine-H1N1, the Novel flu pandemic in the world. In our hospital, we also did the very early patients using the ECMO to rescue less severe Novel H1N1 flu. This is example patients. This was a 28-year old female and the BMI was 35. A little obesity. She had fever and cough for one week. However, when he visited our emergency room, she was intubated on hospital, day 2, and the lung condition deteriorate very quickly. We pull down VV-ECMO on day 3. The rapid tests for flu A plus B were positive and the RT-PCR for swine-H1N1 was positive at that time. By using the ECMO to support the lung, I indicated the CT scan here. It shows that the lung already wear out by deteriorating, which means the lung already loss it's ventilation and perfusion function. Loss the gas exchange and oxygenation function. We start to use the antiviral drugs and broad-spectrum antibiotics, and also use some steroid under ECMO to treat the patient. Fortunately, the patient recovered after 38 days, ECMO support. We can remove ECMO on day 41, remove the endotracheal on day 46, and the patient discharged eventually on day 60. The chest x-ray in outpatient clinic, it showed that the lung recover nearly to be normal. Lung function tests before hospital discharge: the FVC was 32 percent, the FEV1 was 34 percent. But the patient improve in outpatient clinic. The FVC improve to nearly 60 percent and the FEV1 also improve over 60 percent. At that time, we recognize and we learned that the VV-ECMO can treat the severe ARDS patients. This year, all of us knows that there is a COVID-19 pandemic outbreak in the war, and many centers using ECMO to treat the COVID-19 severe ARDS patients. Expert committee suggest that all the personnel in hospital or the hospital workers should have personal protective equipment, and all the facility have to have enough ECMO equipment if they are design to treat the severe COVID-19 patients, and all the facilities which constrain the infective patients have to have stricter infection control procedures, should have protocols for patient transport, and waste disposable protocols. The government, the health system should have communications and coordinations between systems and the system, hospital and the hospital, or government and hospital. The referral, the retrievals, and the reporting system should be established and have career plans and resource allocations to improve the quality, assurance, and the research. The key elements for planning of ECMO service. Developing organizations that support systems, equipment, facilities, and personnel is crucial to ensure optimal patient care, as well as family and staff safety during outbreak of emerging infectious disease. The question is, how long can we support the lung by VV-ECMO? In our hospital, I have experience that we use the VV-ECMO to support drowning patients for 117 days. Now, the supporting duration was the longest duration in the world at that time. We use two set of ECMO to support the patient. In the worst period of this patient, the P/F ratio, which means the PaO_2 over FiO_2 ratios was below 100 for three months. The lung compliance was very poor, below five for two months in the worst period. But however, the condition of lung improved after three months support. The P/F ratio improve, the lung compliance improve, so we can remove the ECMO from these patients. The patient can discharge from hospital by walking and without any support.