Background: Currently, the correction guidelines of shocks of different genesis recommend PiCCO monitoring for infusion and vasopressor therapy. Purpose: assessing the impact of PiCCO technology on the cost/effectiveness principle in the ICU. Material and methods: The retrospective study was performed on a group of 125 critical patients divided into two groups, requiring vasopressors, inotropes or infusion therapy, hospitalized during the period 2017-2018 in ICU of the SCM “Sf. Treime”. The treatment was different depending on the reanimatological syndrome. Patients in group I (n = 60) were subjected to PiCCO-guided intensive therapy by measuring dynamic and volumetric parameters, ScvO2, SaO2, MAP, and group II (n = 65) - intensive therapy guided by measuring static parameters (PVC, ScvO2, MAP), with an insignificant difference in age and sex. Results: According to the study data, patients in group I received a higher APACHE II at hospitalization in ICU (lot I (APACHE 26, ISS 14) versus lot II (APACHE 24 p, ISS score 13), and at the end of the treatment – reduction of the hospitalization time in ICU (lot I (5.4 days) versus lot II (7.8 days) but with insignificant influence on the death rate. At the same time, it was noted a reduction in lethality in patients with ketoacidosis (lot I (14.28%) versus lot II (27.27%) in patients with IRA (lot I (0%) versus lot II (16.66%). Conclusions: Guided intensive therapy with PiCCO technology showed a 2.4 days/bed reduction, which implies lower costs ICU, but with an insignificant impact on lethality rates, especially in cardiogenic shock, septic shock, ARDS (Phase III). At the same time, there was a reduction of lethality in cases of ketoacidosis and IRA.