The Effect of Limiting Fluid Intake on Clinical, Biochemical and Functional Parameters in Compensated Heart Failure Patients at a North Indian Hospital

Author(s): Prafull Sharma1 , Vivek Guleria2 , Salil Garg3 , Gaurav Batta4 , Niket Verma5 , Susheel K. Malani6

BACKGROUND Restriction of fluid is widely adopted as a strategic non-pharmacological therapy for patients with heart failure (HF). However, insufficient fluid leads to intravascular volume contraction further causing hypoperfusion of vital organs. Renal dysfunction and cardiac ischemia caused by hypoperfusion can further aggravate heart failure. Therefore, the authors decided to study the effect of fluid intake on various functional and cardiac parameters of patients of HF. METHODS 50 patients with a diagnosis of heart failure with reduced ejection fraction who had been discharged from the hospital since last 6 months and who were on restricted fluid therapy were included in the study. Patients were advised to visit the OPD once every 4 weeks and provide a record of their fluid intake. All patients irrespective of functional class were advised a fluid intake of 30 mL / day / Kg body weight. Functional status, biochemical parameters and clinical parameters were measured regularly until the end of 12 weeks. RESULTS There was marked improvement in the functional status of patients and statistically significant number was shifted from NYHA III and IV to NYHA I and II. PFI (Prescribed Fluid Intake) was associated with improvement of exercise tolerance in all NYHA Classes. Creatinine levels declined in all NYHA Classes with very high drop from 2.32 to 1.0 in NYHA Class IV. CONCLUSIONS Compensated HF patients should be prescribed physiologically correct dietary fluid intake based on body weight. This improves their functional capacity, biochemical parameters and left ventricular ejection fraction.