Podcast 731: Fluid Resuscitation in Burns

<p><strong>Contributor: Chris Holmes, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Parkland Formula:</span> <strong>4</strong> <span style="font-weight: 400;">mL x [Total Body Surface Area Burned (%)] x [body weight (kg)] given in 24 hours</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">50% given over 8 hours and 50% given over the next 16 hours</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Brooke Formula:</span> <strong>2</strong> <span style="font-weight: 400;">mL x [Total Body Surface Area Burned (%)] x [body weight (kg)] given in 24 hours</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">50% given over 8 hours and 50% given over the next 16 hours</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">2009 military study evaluated Parkland vs. Brooke formulas for severe burn patients and found the outcomes were the same</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Guidelines are in flux on which formula to use, but reducing the overall volume using the Brooke formula can be done without significant change in morbidity or mortality</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Using fluid responsiveness by measuring urine output and signs of fluid overload can help guide overall resuscitative approach in burn patients</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Chung KK, Wolf SE, Cancio LC, et al. Resuscitation of severely burned military casualties: fluid begets more fluid. J Trauma. 2009;67(2):231-237. doi:10.1097/TA.0b013e3181ac68cf</span></p> <p><span style="font-weight: 400;">Schaefer TJ, Nunez L