PhD defence G. (Göksel) Güven

Brief summary:

ystemic macrohemodynamic parameters are traditionally measured for the resuscitation of critically ill patients; however, correcting these parameters does not always mean a parallel improvement in microcirculation. Similarly, patients who recover from a critical illness or have a high risk of progressing to a critical illness may have an undetected microcirculatory compromise, even if they have macrohemodynamic parameters in the normal range. Therefore, this thesis aimed to give insights into the clinical application of microcirculatory monitoring tools for the early detection of vulnerable microcirculation and kidney dysfunction. Therefore, in the first part, we focused on improving the bedside use of microcirculatory monitoring techniques by presenting new findings and paths for accurate clinical assessment. In the second part, we investigated the feasibility and relevance of microcirculation monitoring for detecting vulnerable microcirculation during under or overresuscitation of critically ill patients. Finally, in the third part, we focused on kidney dysfunction in patients with advanced heart failure since we know the kidneys are highly vulnerable to hypoxia and substantially influence survival.