Research Article| Volume 60, ISSUE 6, P682-685, June 2007

Download started.


Resuscitation of thermal injuries in the United Kingdom and Ireland

Published:February 09, 2007DOI:


      The purpose of this study was to examine the consistency of burns resuscitation practice throughout UK and Ireland. Twenty-six Burns Units were identified via the National Burn Bed Bureau and surveyed via a postal questionnaire. Twenty-three units returned a completed questionnaire, covering all of the units treating children and 17 out of 20 units that treat adults.
      Nearly all of the Burns Units commence fluid resuscitation at 10% total body surface area of burn in children and 15% total body surface area of burn in adults. The estimated resuscitation volume is calculated using the Parkland or the Muir and Barclay formula in 76% and 11% of units, respectively. The most commonly used resuscitation fluid is Hartmann's solution. No unit uses blood as a first line fluid. Resuscitation is discontinued after 24 h in 35% of units and after 36 h in 30% of units. Approximately half of the units do not routinely change the type of intravenous fluid administered after the initial period of resuscitation.
      This survey illustrates that resuscitation of thermally injured patients in UK and Ireland Burns Units is fairly consistent with a shift towards crystalloid resuscitation.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Muir I.
        The use of the Mount Vernon formula in the treatment of burn shock.
        Intensive Care Med. 1981; 7: 49-53
        • Baxter C.R.
        Fluid resuscitation, burn percentage, and physiologic age.
        J Trauma. 1979; 19: 864-865
        • Baxter C.R.
        Guidelines for fluid resuscitation.
        J Trauma. 1981; 21: 687-889
        • Fakhry S.M.
        • Alexander J.
        • Smith D.
        • et al.
        Regional and Institutional variation in burn care.
        J Burn Care Rehabil. 1995; 16: 86-90
        • Wharton S.M.
        • Khanna A.
        Current attitudes to burns resuscitation in the UK.
        Burns. 2001; 27: 183-184
        • Cochrane Injuries group Albumin Reviewers
        Human albumin administration in critically ill patients: systemic reviews of randomised controlled trials.
        Br Med J. 1998; 317: 235-240
        • Pruitt B.A.
        Protection from excess resuscitation: “pushing the pendulum back.”.
        J Trauma. 2000; 49: 567-568
        • American College of Surgeons Committee on Trauma
        Advanced Trauma and Life Support® for doctors.
        American College of Surgeons, Chicago1997
        • Cartotto R.C.
        • Innes M.
        • Musgrave M.A.
        • et al.
        How well does the Parkland formula estimate actual fluid resuscitation volumes?.
        J Burn Care Rehabil. 2002; 23: 258-265
        • Murison M.S.
        • Laitung J.K.
        • Pigott R.W.
        Effectiveness of burns resuscitation using two different formulae.
        Burns. 1991; 17: 484-489
        • Holm C.
        Resuscitation in shock associated with burns. Tradition or evidence-based medicine?.
        Resuscitation. 2000; 44: 157-164
        • Ahrns K.S.
        Trends in burn resuscitation: shifting the focus from fluids to adequate endpoint monitoring, edema control, and adjuvant therapies.
        Crit Care Nurs Clin North Am. 2004; 16: 75-98
        • Roberts I.
        • Alderson P.
        • Bunn F.
        • et al.
        Colloids versus crystalloids for fluid resuscitation in critically ill patients.
        Cochrane Database Syst Rev. 2004; 4
        • Alderson P.
        • Bunn F.
        • Lefebvre C.
        • et al.
        Human albumin solution for resuscitation and volume expansion in critically ill patients.
        Cochrane Database Syst Rev. 2004; 4
        • Greenhalgh D.G.
        • Housinger T.A.
        • Kagan R.J.
        Maintanence of serum albumin levels in paediatric burns patients: a prospective randomised trial.
        J Trauma. 1995; 39: 67-74
        • Finfer S.
        • Bellomo R.
        • Boyce N.
        • et al.
        A comparison of saline and albumin for fluid resuscitation in the intensive care unit. The SAFE study investigators.
        N Engl J Med. 2004; 350: 2247-2256
        • Aharoni A.
        • Moscona R.
        • Paltieli Y.
        Pulmonary complications in burn patients resuscitated with a low volume colloid solution.
        Burns. 1989; 15: 281-284
        • O'Mara M.S.
        • Slater H.
        • Goldfarb I.W.
        • et al.
        A prospective, randomized evaluation of intra-abdominal pressures with crystalloid and colloid resuscitation in burn patients.
        J Trauma. 2005; 58: 1011-1018
        • Baxter C.R.
        • Shires G.T.
        Physiological response to crystalloid resuscitation of severe burns.
        Ann NY Acad Sci. 1968; 150: 874-894
        • Baxter C.R.
        Fluid volume and electrolyte changes in the early post-burn period.
        Clin Plast Surg. 1974; 1: 693-703
        • Guha S.C.
        • Kinsky M.P.
        • Button B.
        • et al.
        Burn resuscitation: crystalloid versus colloid versus hypertonic saline hyperoncotic colloid in sheep.
        Crit Care Med. 1996; 24: 1849-1857