Objective: To describe the clinical course of a group of patients who received a rotating inotrope regimen, including levosimendan, for decompensated congestive heart failure.
Design: Case series.
Setting: Pediatric intensive care unit in a tertiary care children's hospital.
Patients: Nine pediatric patients with severe, decompensated heart failure.
Intervention: The study patients received a rotating inotrope regimen, including levosimendan, dobutamine, and, in some cases, milrinone.
Measurements and main 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.