In critical care units, the shelf for cardiac output (CO) monitoring devices fills up with ever more innovative systems. Are these techniques useful, or are they expensive and irrelevant gadgets? There are arguments to defend both viewpoints. In this commentary, which we have drawn up as a “pro–con debate”, we expose these arguments and deliver our opinion. Along with recommendations, it is reasonable today to defend CO monitoring in patients with shock. Of course, it should be reserved for the most critical cases, when initial treatment is ineffective.

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