• Lindsay M Ryerson, Peta M A Alexander, Warwick W Butt, Frank A Shann, Daniel J Penny, and Lara S Shekerdemian.
• Intensive Care Unit Registrar, Royal Children's Hospital, Melbourne, Australia. ryerson@ualberta.ca
• Pediatr Crit Care Me. 2011 Jan 1;12(1):57-60.

ObjectiveTo describe the clinical course of a group of patients who received a rotating inotrope regimen, including levosimendan, for decompensated congestive heart failure.DesignCase series.SettingPediatric intensive care unit in a tertiary care children's hospital.PatientsNine pediatric patients with severe, decompensated heart failure.InterventionThe study patients received a rotating inotrope regimen, including levosimendan, dobutamine, and, in some cases, milrinone.Measurements And Main ResultsSix 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.ConclusionsRotating 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.

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