Fluid requirements of severely burned children up to 3 years old: hypertonic lactated saline vs. Ringer's lactate-colloid

Abstract

Children with burns ⩾ 30 per cent of the body surface area were entered into a prospective fluid resuscitation protocol using hypertonic lactated saline (HLS) or Ringer's lactate-colloid. The two resuscitation groups were subdivided into patients ⩽3 years old and children >3 vears old. The children under 3 years old required significantly more fluid and sodium during the first 48 h when calculations were made using body weight as the indexing factor. When fluid and sodium needs of paediatric age groups were calculated using body surface area as the indexing factor, significant differences in fluid and sodium requirements were no longer present between age groups. This suggests that these observed differences may reflect the difference in surface area to mass ratio for these age groups. Children resuscitated with HLS require 23 per cent less fluid in the first 24h. If body weight is used for estimating fluid needs, clinicians should be aware of the differences in fluid requirements for children ⩽3 years old compared with older paediatric patients. Formulas for estimating fluid needs are presented.