Another important factor affecting fluid requirement after severe burn: a retrospective study of 166 burn patients in Shanghai

Abstract

Background: The modified Evans formula is the most often used schema for calculating intravenous resuscitation fluid requirement in burn patients in China, including two parameters: body weight and burnt body surface area (BBS). The aim of this retrospective study was to analyse depth of wound influencing intravenous fluid replacement in addition to these two factors.

Methods: We reviewed the records of 166 patients admitted in Shanghai Ruijin Hospital during 2000-2008 whose BBS was larger than 25% total body surface area (TBSA). The modified Evans formula was used in all patients. The volume of fluid therapy was determined by urinary output.

Result: In the first and second 24 h the volume of intravenous fluid resuscitation per bodyweight per BBS (VIWB) showed a significant positive correlation to full-thickness burn size ratio (FBSR: full thickness BBS/total BBS) (R(2)=0.138, P<0.001; R(2)=0.108, P<0.001). The volume of fluid resuscitation was not different than the modified Evans formula in superficial burn only patients. Each 20% increase in full-thickness burn size ratio increased 0.1 in volume infused per bodyweight per BBS in the first 24 h afterburn and 0.06 in the second 24 h.

Conclusion: Full-thickness burn wounds received more volume of intravenous fluid than superficial burn wounds, especially in the second 24 h afterburn. The formula meets the fluid predictions of different depth of wound by using the modified fluid coefficients.