A fluid shift from intravascular to interstitial spaces due to Increased vascular permeability from disrupted capillaries.Local vasoconstriction and systemic vasodilation form inflammatory and vasoactive mediators.Intracellular sodium shift contributes to hypovolemia and cellular oedema.Key components of the physiological changes during a burn are: It is a combination of distributive, cardiogenic, and hypovolemic shock. Tip: Adequate volume resuscitation can preserve the zone of stasis and prevent further fluid loss.īurn shock begins at a cellular level ( Baxter 1968, Moyer 1965, Arturson 1979). Avoid ischemic extension of the burn wound.This goal is achieved in the following ways: The goal of fluid resuscitation is to prevent rather than treat burn shock. More globally speaking, the following two are recommended guidelines for fluid resuscitation in a burn based on burn size. The American Burns Association state that "burns greater than 20% TBSA should undergo formal fluid resuscitation using estimates based on body size and surface area burned" ( Pham et al, 2008). Too much fluid can result in oedema and cardiac and respiratory compromise.Įvidence-based flashcards to improve your active recall. This can be due to under-or over-resuscitation. Maintenance with 5% dextrose & resuscitation fluid to overcome proportionally greater surface area & reduced hepatic glycogen stores. The Parkland Formula (4mL x %TBSA x kg) is the most widely used formula for the first 24 hours of fluid resuscitation Most formulas are based on Hartmans/Ringers Lactate. Table 2.Fluid resuscitation is indicated in burns 10% TBSA in children.įluid shifts from intravascular to interstitial spaces, intracellular sodium shifts, local vasoconstriction, and systemic vasodilation.Ĭrystalloids and colloids are the mainstays of fluids in burns resuscitation.Example: A 35 kg child minimum hourly fluid intake would be: (4x10) + (2x10) + (1x15) = 75 cc/hour.20 cc/kg/24 hours= 1 cc/kg/hour for the remaining weight.50 cc/kg/24 hours= 2 cc/kg/hour for the 2nd 10 kg of the patient's weight.
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