Types-based market taxonomy distinguishes pump head design, oxygenator chemistry and monitoring intelligence. Veno-arterial (VA) systems dominate, accounting for 57 % of 2023 shipments; their dual-circulation support keeps average selling prices (ASP) above USD 32 k and justifies service contracts that lock customers into 5-year disposables pipelines. Veno-venous (VV) configurations hold 31 % share, favoured in respiratory-only failure; competition among integrated centrifugal pumps has compressed ASPs 4 % CAGR since 2019, forcing suppliers to bundle heparin-coated circuits to protect margin. Arterio-venous (AV) pumpless models, though only 7 % of units, serve resource-limited ICUs where capital budgets are < USD 25 k; adoption is flat because of staff compliance issues. Finally, ECMO with integrated renal-replacement—a 5 % slice—commands the highest software subscription upsell, adding USD 6 k annually per licence and clarifying why manufacturers now prioritise modular platforms over standalone consoles.