The investigators searched PubMed, the Cochrane Library, Web of Science, Embase, and ClinicalTrials.gov, with a final search on February 9, 2026. The review followed JBI and PRISMA-ScR methods, used a registered protocol, and involved independent screening by two reviewers. Eligible reports compared at least two ECMO–RRT approaches and linked those configurations to reported outcomes.

From 6,806 retrieved records, 20 studies were included: 12 clinical studies, three laboratory studies, one computational study, and four practice surveys. Only one clinical study was a randomized controlled trial. Two clinical studies involved pediatric patients, and adult studies enrolled between 12 and 170 patients. Differences in populations, equipment, anticoagulation, and outcome definitions limited direct comparison.