Guner YS, et al. - Authors tested the hypothesis that using a propensity score (PS) approach to account for selection bias could identify outcome differences based on extracorporeal membrane oxygenation (ECMO) modality for infants with congenital diaphragmatic hernia (CDH). As per data, there was no significant impact of ECMO mode on mortality or severe neurologic injury (SNI) in infants with congenital diaphragmatic hernia (CDH). Survival was favoured by venoarterial (VA) in the subset of infants who required pre-ECMO CDH repair, whereas, venovenous (VV) favored lower rates of SNI in the subgroup of infants who did not have pre-ECMO CDH repair. Consistent superiority across all situations was not seen in either mode. Clinical judgment should remain a multifactorial decision.