American Burn Association Practice Guidelines Burn Shock Resuscitation

Abstract : There are insufficient data to support a treatment standard treatment at this time. Guidelines - Adults and children with burns greater than 20% TBSA should undergo formal fluid resuscitation using estimates based on body size and surface area burned. - Common formulas used to initiate of resuscitation estimate a crystalloid need for 2 to 4 ml/kg body weight/%TBSA during the first 24 hours. - Fluid resuscitation,regardless of solution type or estimated need, should be titrated to maintain a urine output of approximately 0.5 1.0 ml/ kg/hr in adults and 1.0 1.5 ml/kg/hr in children. - Maintenance fluids should be administered to children in addition to their calculated fluid requirements caused by injury. - Increased volume requirements can be anticipated in patients with full-thickness injuries, inhalation injury, and a delay in resuscitation. Options - The addition of colloid-containing fluid following burn injury, especially after the first 12 to 24 hours postburn, may decrease overall fluid requirements.