Gasto energético basal em idosos com insuficiência cardíaca / Resting energy expenditure in elderly patients with heart failure

Na insuficiência cardíaca descompensada há aumento de gasto energético basal e, frequentemente, redução do consumo alimentar, associado também ao envelhecimento. Assim, o objetivo foi verificar o consumo alimentar e o gasto energético basal em idosos com insuficiência cardíaca. Métodos: Estudo transversal com pacientes com insuficiência cardíaca congestiva descompensada, divididos em idosos (> ou igual 60 anos) e não idosos (< 60 anos). O consumo alimentar foi medido pelo método direto de pesagem e o gasto energético basal foi medido pela calorimetria indireta e foi comparado com a fórmula de Harris-Benedict. A relação entre o gasto energético basal medido pela calorimetria indireta e Harris-Benedict foi feita pelo método de Bland-Altman, p<0,05. Resultados: Foram estudados 55 pacientes, 12 idosos, 43 não idodos. A fração de ejeção nos idosos foi 26% (DP=11,45) e nos adultos de 25,2% (DP=11,2%). O gasto energético basal pela calorimetria indireta foi de 1.165 (DP=447)kcal para os idosos e 1.367(DP=532)kcal para os adultos (p=0,236). Por Harris-Benedict, o gasto enerético basal foi de 1.248 (DO=160)kcal para os idosos e de 1.372 (DP=169)kcal para os adultos (p=0,028). O consumo alimentar dos idosos foi de 1.916(DP=643)kcal e dos adultos foi de 1.910(DP=638)kcal. Houve concordância entre o gasto energético basal pela calorimetria indireta e Harris-Benedict (p=0,001;R=0,435). Conclusão: O consumo alimentar e o gasto energético basal dos idosos foram semelhantes aos dos não idosos, Houve concordância e uma correlação positiva entre a calorimetria indireta e a fórmula de Harris-Benedict.

In decompensate heart failure there is an increased resting energy expenditure and often a reduction in food intake, also associated with aging. The objective was to assess food intake and resting energy expenditure in elderly patients with heart failure. Methods: This was a cross-sectional study of patients with decompensate congestive heart failure and were divided into elderly (> ou igual 60 years) and nonelderly (< 60 years). Food intake was measured by the direct method of weighing and resting enegy expenditure was measured by indirect calorimetry and was compared with the Harris-Bendict formula. The relationship between resting energy expenditure measured by indirect calorimetry and Harris-Benedict was made by a Band-Altman, p<0,05. Results: We studied 55 patients, 12 elderly, 43 nonelderly. The ejection fraction in elderly patients was 26% (SD=11,4%) of adults and 25,2%(SD==11,2%). The resting energy expenditure by indirect calorimetry was 1.165(SD=447)kcal for the elderly and 1.372(SD=532)kcal for adults(p=0,236). For the Harris-Benedict resting energy expenditure was 1.248(SD=160)kcal for the elderly and 1.372(SD=169)kcal for adults(p=0,028). The food intake of elderly was 1.916(SD=643)kcal and adults was 1.910(SD=638)kcal. There was agreement between resting energy expenditure by indirect calorimetry and Harris-Benedict (p=0,001,R=0,435). Conclusions: Dietary intake and resting expenditure of the elderly were similar to those of non-elderly. There was agreement and a positive correlation between indirect clorimetry and the Harris-Benedict formula.

Assessment of food intake in infants between 0 and 24 months with congenital heart disease.

BACKGROUND: Children with congenital heart disease are usually malnourished and present some degree of functional and/or structural impairment of organs. There is also deficiency in nutrient intake, due to the control of fluids required by some patients which restrains the nutrient intake of some cardiac children. OBJECTIVE: To assess the food intake of children with congenital heart disease hospitalized in the pediatric heart unit of a "Public Teaching Hospital". METHODS: The intake of food and nutrients was calculated based on the food consumed during three days (direct weighting method) and the calories and nutrients were calculated using the Virtual Nutri software. RESULTS: The intake of calories per kilogram of body weight, of daily proteins, sodium and vitamin A was within the recommended levels (p < 0.05). However, the intake of daily calories, fats, fiber, potassium and iron was below the recommended levels (p < 0.05) and the intake of proteins per kilogram, carbohydrates, calcium and vitamin C was above the recommended levels (p < 0.05). CONCLUSION: Children with congenital cardiopathy have inadequate diets, and therefore, need nutritional guidance to foster adequate dietary intake and the resulting improvement in growth and weight and height development, guaranteeing better quality of life to the patients.

Avaliação do consumo alimentar de crianças de 0 a 24 meses com cardiopatia congênita / Assessment of food intake in infants between 0 and 24 months with congenital heart disease

FUNDAMENTO: As crianças com cardiopatia congênita geralmente são desnutridas e apresentam algum grau de comprometimento funcional e/ou estrutural dos orgãos. Existe, ainda, uma deficiência na ingestão de nutrientes, corroborada pelo controle hídrico, que limita o aporte nutricional de alguns cardiopatas. OBJETIVO: Avaliar o consumo alimentar de crianças com cardiopatia congênita internadas na Unidade de Pediatria Cardiológica de hospital-escola público. MÉTODOS: O consumo de alimentos e nutrientes foi calculado pelo consumo alimentar de três dias (método direto de pesagem) e o cálculo das calorias e nutrientes foi feito pelo software Virtual Nutri. RESULTADOS: O consumo de calorias/kg peso, de proteínas diárias, de sódio e de vitamina A esteve dentro do recomendado (p < 0,05). Todavia, as calorias diárias, os lipídios, as fibras, o potássio e o ferro estiveram abaixo do recomendado (p < 0,05) e, as proteínas/kg peso, os carboidratos, o cálcio e a vitamina C estiveram acima do recomendado (p < 0,05). CONCLUSÃO: Crianças com cardiopatia congênita têm dietas inadequadas e, portanto, necessitam de orientação nutricional para haver ingestão dietética adequada e conseqüente melhora do crescimento e do desenvolvimento pondo-estatural, garantindo melhor qualidade de vida aos pacientes.

BACKGROUND: Children with congenital heart disease are usually malnourished and present some degree of functional and/or structural impairment of organs. There is also deficiency in nutrient intake, due to the control of fluids required by some patients which restrains the nutrient intake of some cardiac children. OBJECTIVE: To assess the food intake of children with congenital heart disease hospitalized in the pediatric heart unit of a "Public Teaching Hospital". METHODS: The intake of food and nutrients was calculated based on the food consumed during three days (direct weighting method) and the calories and nutrients were calculated using the Virtual Nutri software. RESULTS: The intake of calories per kilogram of body weight, of daily proteins, sodium and vitamin A was within the recommended levels (p < 0.05). However, the intake of daily calories, fats, fiber, potassium and iron was below the recommended levels (p < 0.05) and the intake of proteins per kilogram, carbohydrates, calcium and vitamin C was above the recommended levels (p < 0.05). CONCLUSION: Children with congenital cardiopathy have inadequate diets, and therefore, need nutritional guidance to foster adequate dietary intake and the resulting improvement in growth and weight and height development, guaranteeing better quality of life to the patients.