Fluid resuscitation is typically indicated when the Total Body Surface Area (TBSA) % of burns (2 ^nd & 3 ^rd degree only) exceed 15% (10% in pediatrics). 

Several equations exist, including the Parkland and Galveston formulas.

It is emphasized that all burn fluid equations serve as a starting point for fluid resuscitation and often require modification relating to patient status.  Many experts believe urine output is a critical issue to monitor fluid needs and should be maintained at 0.5-1.0 mL/kg/hr (adults/adolescents) and 1 mL/kg/hr (children).

These fluids are IN ADDITION to standard maintenance fluids which need to be administered in addition to the amount calculated, which is a calculation of fluids relating to the burn itself.

The Modified Brooke formulas are (for 1 ^st 24 hours):

Adults/Adolescent: mL LR=2*Weight(kg)*%Burn
Children: mL LR=3*Weight (kg)*%Burn

The modified Brooke formula employs Lactated Ringers (LR) as preferred solution because of its more nearly physiologic concentration of chloride, sodium and pH as compared to normal (0.9%) saline.

Additional Notes

One half of the calculated estimate is administered in the first 8 hours and the second half over the subsequent 16 hours.

In case of delay in the initiation of fluid resuscitation the amount of fluid calculated to be administered in the first 8 hours should be infused at a rate such that half of the estimated 24 hour fluid requirement will be delivered by 8 hours postburn.

In the second 24 hours post burn, this protocol calls for 0.3-0.5 mL/kg/%burn of colloid containing fluid equivalent to plasma (for example fresh frozen plasma), with the addition of D5W as necessary to maintain urine output.

References

Blumetti J, et al. The Parkland Formula Under Fire: Is the Criticism Justified? J Burn Care Res. 2008 Jan-Feb;29(1):180-6.

Kumar P. Fluid resuscitation for burns; a double edge weapon. Burns. 2002 Sep;28(6):613-4.

Warden GD. Burn shock resuscitation. World J Surg. 1992 Jan-Feb;16(1):16-23.