In the last three years an interdisciplinary ECMO (extracorporeal membrane oxygenation) team has been set up at the Free University of Berlin in the Steglitz clinic. With this form of management, newborns only a few hours or days old who present with pulmonary failure can temporarily be managed with extracorporeal oxygenation until normal lung function is restored. The set up of this ECMO team, starting with experimental training in animal models, to the bedside clinical use is discussed. The following presentation of the first four cases managed here with ECMO aims to clarify the problems which may be encountered as well as amplifying its use as a life-saving measure.