The major cause of malnutrition in the case of the child
with CHD is the lack of balance between the total energy
expenditure (TEE) and limited endogenous substrate
reserves (6). Energy expenditure in children with CHD is
increased. TEE includes basal metabolic rate (BMR) and
energy expended daily for thermoregulation, physical
activities, and growth. BMR represents the major
component of TEE and a metabolizable energy intake, used
for the maintenance of basic life functions: heart function,
breathing, and basic cellular function. The BMR of infants
is almost twice that of adults per kilogram of body weight
(6, 20).