An adequate correction of instability and tissue hypoperfusion during a proper time before the occurrence of irreversible shock is essential. ICON™ was utilized to detect increased thoracic fluid content (TFC) in ECMO patients. Objective: This study was conducted to detect increased intrathoracic fluid content in ECMO patients and the accuracy of ICON™ to predict fluid responsiveness. Patients and methods: This study is a prospective cross-sectional study on ten adult patients who were admitted to critical care department, Cairo University over a period of twenty months starting from June 2020 to February 2022and were eligible to ECMO (both VA and VV ECMO). Hemodynamic monitoring using Electrical cardiometry was done using ICON™. ICON™ was utilized to detect increased thoracic fluid content and predict fluid responsiveness. Assessment of fluid responsiveness was evaluated clinically and or by giving fluid challenge and recalculation of stroke volume using echocardiography if increased by 12 % or more considered fluid responder. Results: ICON™ can used to detect increased intrathoracic fluid content and there was statistically significant positive correlation with ECMO flow and in VV ECMO group but statistically significant negative correlation in venoarterial ECMO group. ICON™ can predict fluid responsiveness in patients connected to venovenous ECMO and the cut of point was 12.5% increase in cardiac output in fluid responders. Conclusion: ICON™ can predict fluid responsiveness in patients connected to VV ECMO.