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, Galveston and Brooke formulas. This formula is for ADULTS ONLY.

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).

These fluids are IN ADDITION to standard maintenance fluids which may need to be administered in addition to the amount calculated depending upon urinary output.

Plasma proteins play an important role in maintaining oncotic pressure in the blood vessels and maintaining intravascular volume. The Slater formula utilizes Fresh Frozen Plasma (FFP) as a result of this principle, along with Lactated Ringers (LR).

This physical principle is the basis of formulations of Slater formula which recommended usage of Fresh Frozen Plasma for fluid resuscitation along with Lactated Ringers (LR) at 2 L/24 hr (83 mL/hr).

The Slater formula for Adults (for 1 ^st 24 hours):

• LR: 2 liters/24 hrs = 83 mL/hr
• Fresh Frozen Plasma: 75 mL/kg/24 hrs

^* Note: The use of fresh frozen plasma for resuscitation of extensively burned patients has been associated with minimal weight gain and minimal edema.

References:

1. Slater H, Slater H, Goldfarb IW. Influences of different resuscitation regimens on acute early weight gain in extensively burned patients. Burns . 1991;17(2):147-50.
2. Ullmann Y, Kremer R, Ramon Y, et al. Evaluation of the validity of the Haifa Formula for fluid resuscitation in burn patients at the Rambam Medical Centre. Annals of Burns and Fire Disasters . 2000;13(4).
3. Yowler CJ, Fratianne RB. Current status of burn resuscitation. Clin Past Surg . 2000;27(1):1-10.