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Venovenous extracorporeal membrane oxygenation is increasingly being established as a treatment option for severe acute respiratory failure. We sought to evaluate the impact of a dedicated specialist team-based approach on patient outcomes. Retrospective cohort study. Single-center medical ICU in an academic tertiary hospital. Adult patients initiated on venovenous extracorporeal membrane oxygenation for severe acute respiratory failure. Initiation of an extracorporeal membrane oxygenation intensivist-led multidisciplinary team; critical decisions o