Citation: Journal of Pain & Symptom Management. , 2017 Oct 10.Journal: Journal of pain and symptom management.Published: 2017ISSN: 0885-3924.Full author list: Malotte K; Saguros A; Groninger H.UI/PMID: 29030210.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Union Memorial Hospital | MedStar Washington Hospital CenterDepartment(s): Medicine/Palliative CareActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1016/j.jpainsymman.2017.09.026 (Click here)Abbreviated citation: J Pain Symptom Manage. , 2017 Oct 10.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007.Abstract: Heart failure experts recommend initiation of continuous inotrope therapy, such as milrinone or dobutamine, for clinically decompensating patients with stage D heart failure. Although originally intended to serve solely as a bridge to more definitive surgical therapies, more and more patients are receiving inotrope therapy for purely palliative purposes. In these cases, questions arise regarding care at the end of life. What criteria determine ongoing clinical benefit? Should the inotrope be continued until death? Should inotrope dosing be increased within recommended guidelines to improve symptoms? What is the role of inotropes in hospice care? Here, we describe such a case as a springboard to contemplate the evolving role of inotrope therapies and how hospice and palliative providers may interface with this rapidly developing face of advanced heart failure care.Abstract: Copyright (c) 2017. Published by Elsevier Inc.