Research Mentor Name
Research Mentor Email Address
Institution / Department
Children's Hospital of Michigan
Level of Research
Fluid resuscitation for pediatric burns uses formulas that estimate fluid requirements based on weight, and/or body surface area (BSA) along with percent total burn surface area (TBSA). Adult studies have shown that these formulas can cause fluid overload in obese patients and increase risk of complications. These findings have not been validated in pediatric patients. This study provides a retrospective review conducted with 110 children (≤ 18 years old) admitted to an ABA-verified urban pediatric burn center from October 2008 to May 2020. Patients were resuscitated with the weight-based Parkland formula, and had fluids titrated to urine output every two hours. BSA-based Galveston and BSA-incorporated Cincinnati formula resuscitation predictions were also calculated. Complications were collected throughout the hospital stay. Patients were classified into CDC-defined weight groups based on percentile ranges. We found that predicted resuscitation volumes increased as CDC percentile increased for all three formulas (p=0.033, 0.092, 0.038), however there were no significant differences between overweight and obese children. Total fluid administered was higher as CDC percentile increased (p=0.023). However, overweight children received more total fluid than obese children. The difference between total fluids given and Galveston predicted resuscitation volumes were significant across all groups (p=0.042); however, the difference using the Parkland and Cincinnati formulas were not statistically significant. There were more children in the normal weight group who developed complications compared to other groups, but these findings were not significant. Overall, the Parkland formula tended to underpredict fluid needs in the underweight, normal, and overweight children, and it overpredicted fluid needs for the obese. Further research is needed to determine the value of weight-based vs BSA-based or incorporated formulas in terms of their risk of complications.
Medicine and Health Sciences
Stevens, Jan; Prieto, Nina; Ridelman, Elika Ph.D; Klein, Justin D. MD; and Shanti, Christina MD, "Weight-based vs. BSA-based Fluid Resuscitation Predictions in Pediatric Burn Patients" (2021). Medical Student Research Symposium. 117.