Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
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Multicenter Study Clinical Trial
Effectiveness and safety of levosimendan in clinical practice.
In previous randomized studies levosimendan improved hemodynamics and clinical course, with a still unclear effect on prognosis. There are, however, few data regarding its effects when used in daily practice. ⋯ In daily practice, levosimendan was clinically effective and safe in 80.6% and 79.7% of patients with acute SHF at 24 hours and 5 days respectively after the beginning of treatment. A marked reduction in the number of days of hospitalization for heart failure was also seen during the subsequent six months.
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To identify factors associated with "do-not-resuscitate" (DNR) decisions in patients who suffer cardiac arrest. ⋯ This is the first study aimed at identifying factors associated with DNR decisions in a Portuguese hospital with an organized emergency system. DNR decisions were taken in 33% of cases of cardiac arrest. Advanced age, cancer, and no measures initiated before arrival of the MET were associated with the DNR decision. These findings need to be confirmed in larger studies and should be taken into account when taking DNR decisions.