This study aimed to evaluate the effectiveness of hemodynamic therapy in critically ill patients, specifically comparing three treatment groups: a control group with a normal cardiac index target, a cardiac-index group aiming for supranormal values, and an oxygen-saturation group targeting normal mixed venous oxygen saturation. The study involved 762 patients from 56 intensive care units, randomly assigned to the three groups. The primary outcomes were mortality up to discharge from the ICU and six months post-randomization, as well as morbidity measured by the number of dysfunctional organs. The results showed that only 44.9% of patients in the cardiac-index group achieved their target, compared to 94.3% in the control group and 66.7% in the oxygen-saturation group. Despite the higher intensity of treatment in patients who did not reach their targets, there were no significant differences in mortality or morbidity among the three groups. The study concluded that achieving supranormal cardiac index or normal mixed venous oxygen saturation does not reduce morbidity or mortality in critically ill patients.This study aimed to evaluate the effectiveness of hemodynamic therapy in critically ill patients, specifically comparing three treatment groups: a control group with a normal cardiac index target, a cardiac-index group aiming for supranormal values, and an oxygen-saturation group targeting normal mixed venous oxygen saturation. The study involved 762 patients from 56 intensive care units, randomly assigned to the three groups. The primary outcomes were mortality up to discharge from the ICU and six months post-randomization, as well as morbidity measured by the number of dysfunctional organs. The results showed that only 44.9% of patients in the cardiac-index group achieved their target, compared to 94.3% in the control group and 66.7% in the oxygen-saturation group. Despite the higher intensity of treatment in patients who did not reach their targets, there were no significant differences in mortality or morbidity among the three groups. The study concluded that achieving supranormal cardiac index or normal mixed venous oxygen saturation does not reduce morbidity or mortality in critically ill patients.