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Relative fluid restriction

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Relative fluid restriction

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Patients with heart failure often have a tendency to retain salt and water in the body and in the blood circulation. This can lead to an additional burden on the heart with accumulation of fluid in the lungs, increased shortness of breath and/or swelling of the feet and/or legs.

That is why it is often recommended not to drink too much. This is especially important for patients who need to take water pills (water tablets, diuretics). In these patients, drinking too much may lead to the need for a higher dose of diuretics and therefore a need to urinate more.

For patients who should not take diuretics, this advice is less strict as long as there are no signs that the body is retaining fluid (increasing weight, increasing shortness of breath, swelling of the lower legs).

Specific advice regarding fluid limitation:

  • Drink when you are thirsty.
  • Maximum 1.5 to 2 liters per day, all drinks included: water, soft drinks, coffee, tea, soup, milk, etc.
  • The higher the dose of diuretics required and the higher the tendency to retain fluid, the stricter the fluid restriction should be.
  • In patients who receive renal replacement therapy (dialysis) and no longer urinate themselves, fluid restriction must be followed even more strictly.

Tips:

  • Spread the permitted amount of fluid intake over the entire day.
  • Take medication with a meal and not separately with a glass of water.
  • Use small glasses and cups instead of large glasses or mugs .
  • Chew well. This causes more saliva production.
  • More very cold or very hot drinks . These are drunk more slowly.
  • Limit caffeinated and alcoholic drinks.
  • Spreadable toppings (jam, syrup, cottage cheese) . This makes a bread meal less dry than dry toppings (for example sliced cheese) and therefore reduces the need to
  • Options to reduce the feeling of thirst :
    • Rinse the mouth regularly with water and spit it out.
    • Sucking on an ice cube or a piece of candy.
    • Add lemon juice to water or tea.
    • Chewing gum (without sugar). This increases saliva production.
    • Eating small pieces of chilled or frozen fruit.

When can more fluid be consumed?

  • On very hot summer days, when people sweat more than normal. More fluid is then lost through breathing and sweating. You can then drink 1 to 2 glasses more per day (= 150-300 ml).
  • With fever, vomiting and/or diarrhea, more fluid is lost and more fluids may be consumed.
  • In these circumstances it may sometimes be necessary to stop the diuretics (water pills) for a few days as long as the weight remains stable and there is no increase in shortness of breath or swelling of the lower legs.
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