title: Rotating inotrope therapy in a pediatric population with decompensated heart failure.
abstract: OBJECTIVE
  To describe the clinical course of a group of patients who received a rotating inotrope regimen, including levosimendan, for decompensated congestive heart failure.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Pediatric intensive care unit in a tertiary care children's hospital.
  
  
  METHODS
  Nine pediatric patients with severe, decompensated heart failure.
  
  
  METHODS
  The study patients received a rotating inotrope regimen, including levosimendan, dobutamine, and, in some cases, milrinone.
  
  
  RESULTS
  Six patients were weaned from positive-pressure ventilation. Eight patients were discharged from the intensive care unit, and seven survived to hospital discharge. Two patients were successfully bridged to orthotopic cardiac transplantation. The therapies were generally well tolerated.
  
  
  CONCLUSIONS
  Rotating inotropes were safe and seemed to be effective in this heterogeneous population of infants and children with decompensated heart failure. This therapeutic regimen warrants prospective comparative analysis.
authors.affiliation: Intensive Care Unit Registrar, Royal Children's Hospital, Melbourne, Australia. ryerson@ualberta.ca
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Ryerson
authors.forename: Peta M A
authors.initials: PM
authors.lastname: Alexander
authors.forename: Warwick W
authors.initials: WW
authors.lastname: Butt
authors.forename: Frank A
authors.initials: FA
authors.lastname: Shann
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Penny
authors.forename: Lara S
authors.initials: LS
authors.lastname: Shekerdemian
mesh_terms: D000293:Adolescent; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004280:Dobutamine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D020105:Milrinone / Q000627:therapeutic use*; D011724:Pyridazines / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077464:Simendan; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D004280:Dobutamine; D020105:Milrinone