Fluid requirements were calculated according to the Parkland Formula [(Parkland Formula=4 cc/kg/% of TBSA, administered over 24 hours since the time of injury (50% given during the first eight hours and 50% given during the next 16 hours)] (5-7).
Patient demographics and 24-hour intravenous fluid requirements per Parkland Formula Patient Age % of TBSA Weight IVT requirement (years) burned (kg) (Parkland Formula cc/24 hours) 1 48 20 60.
Fluid calculations were based on the Parkland formula at 4 ml/kg/% burn, and a major goal of resuscitation was to maintain urine output above 2 ml/kg/h.
Over-reliance on the Parkland formula, and attempts at maintaining fluid output above 2 ml/kg/h as prescribed by APLS,2 may lead to over-hydration; if severe, this may manifest as compartment syndromes in unburnt limbs and in the abdomen, with potentially lethal consequences.
The pendulum appears to have swung from underresuscitation before use of the Parkland formula towards overhydration, the sequelae encapsulated as 'fluid creep', a term coined by Pruitt.