Abstract

Objective: Evaluation of the effect of Ringer Lactate, as the resuscitative burn fluid according to Parkland Formula, on restoring the levels of body electrolytes and proteins. Design: A retrospective cohort study. Setting: The National Burns Unit, Mafraq Hospital, Abu Dhabi, United Arab Emirates (UAE). Patients: One hundred and fifteen patients admitted with fresh burns between 1st of January 2011 and 31st of December 2013, who met inclusion and exclusion criteria. Methods: Team collected demographic and clinical data for each patient using a standard form. Patients received Ringer Lactate solely as the resuscitative burn fluid according to Parkland Formula. Baseline (pre-) and third-day (post-) variables included levels of sodium, potassium, chloride, proteins, and albumin. Researchers then performed paired comparisons of serum electrolytes and protein levels. Results: Mean values showed maintenance of the potassium and chloride levels within the normal range after administering the Ringer Lactate, significant decline in sodium, and a marked hypoproteinaemia and hypoalbuminaemia post-resuscitation. Conclusions: Ringer Lactate used as the mere resuscitative post burn fluid is suboptimal. Sodium supplementation may be required to correct hyponatremia. Colloids, preferably intravenous albumin should be added, as advised by the original Parkland Formula.

Highlights

  • Fluids constitute the most important health-related intervention in patients with moderate to severe burns [1] [2]

  • Evaluation of the effect of Ringer Lactate, as the resuscitative burn fluid according to Parkland Formula, on restoring the levels of body electrolytes and proteins

  • Patients received Ringer Lactate solely as the resuscitative burn fluid according to Parkland Formula

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Summary

Introduction

Fluids constitute the most important health-related intervention in patients with moderate to severe burns [1] [2]. The original Parkland Formula used colloids on the second day of the burns but this is neglected in most of the burns centers In this formula, clinicians approximate the percent of total body surface area (%TBSA) burned using one or a combination of a number of methods; namely, Lund-Browder [7] [8] [9], Rule of Nines [10] [11], and Palm [12] [13] [14]. They may account for gender differences in %TBSA while arriving at these estimates [15]. Research groups have used new components such as ethyl pyruvate together with RL, survival benefits with such mixtures in animal models of burns await clinical confirmation [16]

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