Factors affecting fluid requirement on the first day after severe burn trauma.
BACKGROUND
Parkland formula (PF) is the most often used schema for calculating intravenous resuscitation fluid requirement in burn patients. Some studies have reported that PF underestimates the fluid requirement in 45-63% of patients. The aim of this retrospective study was to analyse factors influencing first-day intravenous fluid replacement set for a targeted urinary output in severely burnt patients.


METHODS
Data of 47 patients with burn injury affecting equal or more than 15% of body surface area were retrieved from the archived files. The local intensive care protocol rendered the infusion rate of lactated Ringer's solution to achieve a urinary output of 0.5-1.0 mL/kg per hour in the first 24 h after burn trauma.


RESULTS
First-day i.v. infusion volume was significantly higher than PF preferred. In the first 24 h the hourly volume of intravenous fluid resuscitation per bodyweight per burnt surface area showed significant negative correlation to the burnt body surface area and body mass index, (r = -0.553, P < 0.001; r = -0.570, P < 0.001, respectively) no correlation was found to bodyweight, height or patient age. Patients having deep-burn injury required higher intravenous fluid resuscitation rate than patients having superficial injury only (P < 0.01).


CONCLUSIONS
Our data suggest that fluid requirement is higher than predicted by PF if the extent of burn or body mass index is low and less if the extent of burn or body mass index is high. The presence of deep burn increases fluid requirement.
Csontos
Csaba
C
Department of Anaesthesia and Intensive Care, Faculty of Medicine, University of Pécs, 1 Akác Street, Pécs 7632, Hungary. csaba.csontos@gmail.com
Foldi
Viktor
V
Fischer
Tamas
T
Bogar
Lajos
L
D000328:Adult; D015992:Body Mass Index; D001830:Body Surface Area; D002056:Burns / Q000628:therapy*; D016326:Extracellular Matrix Proteins; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D015532:Rehydration Solutions / Q000008:administration & dosage*; D012189:Retrospective Studies; D013997:Time Factors; D014556:Urine
D016326:Extracellular Matrix Proteins; C492373:FBLN5 protein, human; D015532:Rehydration Solutions