Review of intermittent dobutamine infusions for congestive cardiomyopathy.

Dobutamine is a potent inotropic agent traditionally used for treatment of acute cardiac decompensation of congestive heart failure (CHF). It acts primarily by increasing myocardial contractility and cardiac output. It has a rapid onset of action, a half-life of 2 minutes, and a duration of action of 10 minutes. Recently, the therapeutic effect of dobutamine was noted to be prolonged beyond the discontinuation of an infusion, persisting for 4-10 weeks after infusion of 48-72 hours. Because of this prolonged effect, dobutamine infusions were evaluated in outpatients with intractable CHF and were effective in improving their functional status. No effect on survival rates may be expected, but this form of therapy may improve the patient's lifestyle. Although several factors may limit the application of dobutamine infusion to outpatients, it offers an effective alternative to traditional therapy for select patients.