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. 2019 Apr;22(2):113-116.
doi: 10.1016/j.cjtee.2019.01.006. Epub 2019 Mar 2.

Effectiveness of Parkland formula in the estimation of resuscitation fluid volume in adult thermal burns

Geley Ete  1 , Gaurav Chaturvedi  1 , Elvino Barreto  1 , Kingsly Paul M  2
Affiliations

Effectiveness of Parkland formula in the estimation of resuscitation fluid volume in adult thermal burns

Geley Ete et al. Chin J Traumatol. 2019 Apr.

Abstract

Purpose: Acute burn resuscitation in initial 24 h remains a challenge to plastic surgeons. Though various formulae for fluid infusion are available but consensus is still lacking, resulting in under resuscitation or over resuscitation. Parkland formula is widely used but recently its adequacy is questioned in studies. This study was conducted to see how closely the actual volume of fluid given in our center matches with that of calculated volume by Parkland formula.

Methods: All patients admitted with more than 20% flame burn injury and within 8 h of incident were included in this study. Crystalloid solution for infusion was calculated as per Parkland formula; however, it was titrated according to the urine output. Data on fluid infusion were collected from patient's inpatient records and analyzed.

Results: The study included a total of 90 patients, about 86.7% (n = 78) of the patients received fluid less than the calculated Parkland formula. Rate of fluid administered over 24 h in our study was 3.149 mL/kg/h. Mean hourly urine output was found to be 0.993 mL/kg/h. The mean difference between fluid administered and fluid calculated by Parkland formula was 3431.825 mL which was significant (p < 0.001).

Conclusion: The study showed a significant difference in the fluid infused based on urine output and the fluid calculated by Parkland formula. This probably is because fluid infused based on end point of resuscitation was more physiological than fluid calculated based on formulae.

Keywords: Burn resuscitation; Parkland formula; Physiological curve; Urine output.

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Figures

Fig. 1
Fig. 1
Fluid infusion (mL) per body weight (kg) per total body surface area (mL/kg/%TBSA). The above scattered plotting shows the distribution of the rate of fluid infused. The majority are clustered in the range of 2–4 mL/kg/percentage of burns.
Fig. 2
Fig. 2
Physiological curve of fluid infusion requirements shows rate of fluid requirement against time post burn.
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