New Fluid Resuscitation Formula May Have Potential Value for Burn Patients

Kahn SA, Huff ML, Taylor J, et al. Challenging Legacy Burn Resuscitation Paradigms with Fluid Restriction and Early Plasma. J Am Coll Surg. 2025, in press.

Evidence is increasing that supports lower volumes of crystalloid fluid supplemented with fresh frozen plasma (FFP) for resuscitation of burn patients.

This retrospective study compared patients resuscitated with the Parkland formula (n = 116) to patients resuscitated with fluid volumes beginning at 2–3 mL/kg/%burn (n = 97). Body weight was modified according to actual weight + 0.3 + (actual weight–ideal weight). Fluids were titrated, and FFP was administered to achieve urine output of 30 mL/hr. Administered fluid volumes were adjusted upward for patients with electrical injury and large third-degree burns.

Patients resuscitated with the FFP regimen received lower total volumes of fluid and had lower urine output; this group also had lower mortality, lower rates of ventilatory support, and reduced risk of renal failure.

The authors concluded that their formula has potential value for resuscitation of burn patients.