When do you use dobutamine when treating congestive cardiac failure?

Decompensated CHF. Typically when patients are decompensated, such that the physicians cannot remove the fluid without an added squeeze from the heart. It can also be used in cardiogenic shock.
When usual efforts. Fail. Once diuretics and usual efforts fail, then pressure like Dobutamine are used. Typically this is done in ICU or ccu.