Burn Fluid Resuscitation Formulas
1-Harkins formula (1942)
Initial 24 hours:
➧ 1000 ml plasma/10% burn Used in patients with ≥ 10% burn.
2-Body weight burn budget (1947)
Initial 24 hours:
➧ Ringer's lactate (RL) solution 1-4 L + 1200ml NS + 7.5% body weight colloid + 1.5-5 L D5W.
Next 24 hours:
➧ RL 1-4 L + 1200ml NS + 2.5%body weight colloid + 1.5-5 L D5W.
3-Evans formula (1952)
Initial 24 hours:
➧ 0.9% saline at 1 ml/kg/% burn + colloids at 1 ml/kg/% burn + 2000 ml G5W.
Next 24 hours:
➧ 0.9% saline at 0.5 ml/kg/% burn + colloids at 0.5 ml/kg/% burn + 2000 ml G5W.
4-Brooke formula (1953)
Initial 24 hours:
➧ RL solution 1.5 ml/kg/% burn + Colloids 0.5 ml/kg/% burn + 2000 ml G5W.
Next 24 hours:
➧ RL 0.5 ml/kg/% burn + Colloids 0.25 ml/kg/% burn + 2000 ml G5W.
5-Modified Brooke formula (1979)
Initial 24 hours:
➧ RL solution 2 ml/kg/% burn (for adults).
➧ RL solution 3 ml/kg/% burn (for children).
Next 24 hours:
➧ Colloids at 0.3-0.5 ml/kg/% burn.
➧ G5W to maintain good urinary output.
N.B. Pediatric supplementation for children less than 20 kg: RL at calculated maintenance.
6-Parkland formula (Baxter and Shires) (1974)
Initial 24 hours:
➧ RL solution 4 ml/kg/% burn (for adults).
➧ RL solution 3 ml/kg/% burn (for children).
Next 24 hours:
➧ Colloids are given as 20-60% of calculated plasma volume.
➧ G5W is added in amounts required to maintain a urinary output of 0.5-1 ml/kg/h (in adults) & 1 ml/kg/h (in children).
7-Modified Parkland formula
Initial 24 hours:
➧ RL 4 ml/kg/% burn (for adults).
Next 24 hours:
➧ 5% albumin 0.3-1 ml/kg/% burn/16 per h.
8-Consensus (by the American Burn Association)
Initial 24 hours:
➧ RL solution 2-4 ml/kg/% burn.
Next 24 hours:
➧ Colloids at 0.3-0.5 ml/kg/% burn.
➧ G5W is added in the amounts required to maintain good urinary output.
9-Mount Vernon (Muir and Barclay) formula
➧ Used in >15% burn (in adults) or >10% burn (in children).
➧ 1 ml/kg/% burn, Type of fluid: 50% crystalloids + 50% colloids (5% albumin).
➧ This volume is given in each of the following 6 periods: (0-4, 4-8, 8-12, 12-18, 18-24, 24-36h.)
10-Hypertonic saline formula
➧ NS containing: 250 mEq Na⁺ (0.6 ml/kg/% burn) + 1/3 isotonic salt solution orally up to 3500 ml.
11-Monafo (Hypertonic saline) formula (1984)
Initial 24 hours:
➧ NS containing: 250 mEq Na⁺ + 150 mEq lactate⁻ + 100 mEq Cl⁻. The amount is adjusted to maintain a urine output of 30 ml/h.
Next 24 hours:
➧ 1/3 normal saline according to urinary output.
12-Modified hypertonic formula (Metro Health Medical Center)
Initial 24 hours:
➧ RL + 50 mEq NaHCO₃ (180 mEq Na/L) RL 4 ml/kg/% burn titrated to urine output.
Next 24 hours:
➧ ½ NS + One unit FFP/L ½ NS + G5W to prevent hypoglycemia.
13-Slater formula
➧ (RL 2000ml + FFP 75 ml/kg)/24 h.
Formulas developed for children:
1-Shriner's Cincinnati formula
Initial 24 hours:
For older children:
➧ RL solution 4 ml/kg/% of burned tissue (burn-related losses) + 1500 ml/m² total BSA (maintenance fluid) (1/2 of total volume over 8 h, rest of the total volume during the following 16 h).
For younger children:
➧ 4 ml/kg/% of burned tissue (burn-related losses) + 1500 ml/m² total BSA (maintenance fluid).
➧ RL solution + 50 mEq NaHCO₃ in the first 8 h.
➧ RL solution in the second 8 h.
➧ 5% albumin in RL solution in the third 8 h.
2-Galveston formula
➧ Every 1000 ml of the solution consists of 50 ml of 25% albumin added to 950 ml of 5% D5W in the RL solution.
Initial 24 hours:
➧ 5000 ml/m² of burned tissue (burn-related losses) + 2000 ml/m² total BSA (maintenance fluid) (1/2 of total volume over 8 h, rest of the total volume during the following 16 h).
Next 24 hours:
➧ 3750 ml/m² of burned tissue (burn-related losses) + 1500 ml/m² total BSA (maintenance fluid).
Posts
