Clinically significant bleeding is a common complication of extracorporeal membrane oxygenation (ECMO), with bleeding observed in upwards of 40% of patients. Bleeding is strongly associated with systemic anticoagulation, which is typically necessary to reduce the incidence of thrombosis in the extracorporeal circuit. The InFlo MOBYBOX integrates a multimodal strategy for coagulation mitigation, combining optimized circuit components (pump, oxygenator) design with a biopassive hydrophilic surface coating to address both flow-related and surface-mediated contributors to thrombosis and hemolysis. This study investigated whether such a design could reduce thrombotic burden under conditions typically associated with high coagulation risk, low blood flow rates, thereby potentially reducing reliance on systemic anticoagulation.