OBJECTIVE: As survival with extracorporeal membrane oxygenation (ECMO) therapy improves, it is important to study patients who do not survive in the context of withdrawal of life sustaining therapy (WLST). We sought to determine the population and clinical characteristics and to understand those who experienced short latency to WLST. DESIGN: Retrospective cohort study SETTING: Single academic hospital center PARTICIPANTS: Adult ECMO patients INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: 150 patients (mean age 54.8±15.9, 43.3% female,) underwent ECMO (80% venoarterial-ECMO, and 20% venovenous-ECMO) during the study period. 73 (48.7%) patients had WLST from ECMO support at a median of 5 days; 33 (45.2%) patients had early WLST (≦5 day). Patients with WLST were older (49.6±14.7 vs 60.3±15.3, p