Dr Marc Ziegenfuss is currently the President of the Australia and New Zealand Intensive Care Society (ANZICS) and Director of Intensive Care at the Prince Charles Hospital in Brisbane, Australia. Trained in South Africa, England and Australia, his interest in ECMO began in 2008. The Prince Charles Hospital ECMO Service, like many other units in ANZ, was thrown into the deep end – so to speak, with the 2009 H1N1 pandemic. He performed the first Intensivist instituted ECMO run in Queensland and has continued as one of the Senior ECMO Specialists at the Prince Charles Hospital. He recognized early on that “ECMO success” mandates appropriate patient selection and an excellent multidisciplinary treating Team. As a Director he has is frequently asked to justify the use of ECMO from a fiscal perspective.