Rotating inotrope therapy in a pediatric population with decompensated heart failure.
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.
Ryerson
Lindsay M
LM
Intensive Care Unit Registrar, Royal Children's Hospital, Melbourne, Australia. ryerson@ualberta.ca
Alexander
Peta M A
PM
Butt
Warwick W
WW
Shann
Frank A
FA
Penny
Daniel J
DJ
Shekerdemian
Lara S
LS
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
D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D004280:Dobutamine; D020105:Milrinone