Several ARDS cohort studies have evaluated functional improvement over time, and each reports that functional and HRQoL outcomes appear to plateau at 6 months to 1 year after ICU discharge and that most improvements occur within the first 3 to 6 months.3,14 One notable strength of the study by Luyt et al1 is that patients were followed up in their nearest center for clinical investigation and assessed in person. However, patients were evaluated only at 1 year after their critical illness, so there was no opportunity to understand the trajectory of recovery or barriers to rehabilitation along the way. Measurement of outcome at only one time point, which was quite distant from the illness event, may have obscured the ability to detect more-nuanced differences in outcome between the ECLA and the no-ECLA groups. Disability may change over time, and patients may not report or remember more remote issues that have since resolved. One noted difference between groups was the degree of weight loss sustained. The ECLA group lost a median of 6 kg, and the no-ECLA group showed no weight loss. It is possible that this finding may represent an important residual clue that muscle and nerve injury may be heightened or exacerbated by some aspect of ECLA treatment. The authors establish that there are few differences in multiple morbid outcomes at 1 year between patients who did or did not receive ECLA, but they have not helped the reader to know whether the trajectory of recovery was similar or whether important morbidities occurred early that may have impeded return to functional independence or favorable HRQoL. Knowledge of these more proximate outcomes, and especially those believed to be related to mechanical complications (eg, cannula placement, distal limb ischemia, compartment syndromes, ischemic foot drop) or the necessary anticoagulation of ECLA, may influence decision-making about choice of acute treatment modality for these patients.