Cardiac output monitors in septic shock: do they deliver what matters? A systematic review and meta-analysis.

To evaluate the interchangeability of cardiac output (CO) monitoring devices compared to reference methods in adult ICU patients with septic shock, we systematically searched electronic databases through January 2025 for prospective studies comparing CO monitors with pulmonary artery catheter (PAC), transpulmonary thermodilution (TPTD), or echocardiography. Eligible studies included Bland-Altman analysis and, when available, trending assessment via polar or 4-quadrant plots, precision, and time response.  Agreement was defined as percentage error (PE) < 30%, and acceptable trending as concordance ≥ 90%.