PROJECT SUMMARY/ABSTRACT As of May 25th, 2020, there were over 5.5 million confirmed cases of COVID-19 worldwide and around 1.7 million in the US, where almost 100,000 deaths have occurred. Acute Respiratory Distress Syndrome (ARDS) presents secondary to COVID-19 and is primarily treated by mechanical ventilation. Of all hospitalized COVID- 19 patients, around 20% will be intubated and mechanically ventilated. Unfortunately, ARDS patients are especially susceptible to ventilator induced lung injury (VILI) and as many as 80% of intubated COVID-19 patients have died. In contrast, ECMO bypasses the lungs, thereby avoiding VILI, and the patient’s blood is directly oxygenated using an extracorporeal circuit containing a gas-permeable membrane. While ECMO has shown increased survival relative to mechanical ventilation, the complexity of the ECMO procedure, associated bleeding and clotting risks, and labor intensiveness has restricted its use. We propose to develop a new oxygenator membrane constructed from silicon nanopore membranes (SNM). The enhanced biocompatibility and increased gas flux of the SNM will enable the Silicon Membrane Oxygenator (SiMOx) - a compact and potentially anticoagulation-free ECMO system. The SiMOx will establish a new paradigm of “set it and forget it” blood oxygenation that is characterized by decreased operational complexity, diminished bleeding/clotting risks, and reduced personnel needs.