Q. Energy requirement during congestive cardiac failure?

Energy: Composition of the calorie requirements on the basis of body weight is usually not feasible due to the presence of oedema. Thus energy requirements are generally based on the residual cardiac function and the usual body weight of the patient. The need for oxygen support is also an important factor for determining the energy intake needs to be sufficient to meet nutritional needs and prevent deterioration in nutritional status and at the same time care should be taken to avoid a positive energy balance unless so desired. This is so because excessive body mass increases the cardiac workload and weight gain from increased fat stores should be avoided. Gain in adiposity should be distinguished from short term fluctuations in body weight caused by changes in fluid balance. Patients on artificial oxygen support systems And/or those who are obese are recommended 1200 Kcal diet. Ambulatory and /or normal weight patients are usually able to tolerate around 10-25 Kcal/kg IRW or usual body weight per day. Not many efforts are made to increase weight among severely undernourished patients as increased food intake would impose enhanced burden on the heart.