如何计算Parkland Burn Formula

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The Parkland formula guides IV fluid resuscitation for burn patients in the first 24 hours using Lactated Ringer's. Half is given in the first 8 hours post-burn (not transfer).

公式

Fluid (mL) = 4 × Body weight (kg) × %TBSA burned; Give half in first 8 hours, half in next 16 hours; Use Lactated Ringers (LR) solution

Weight: Body weight (kg)
TBSA: Total body surface area burned (Percentage (Rule of 9s))
Fluid4Hrs: Fluid in first 8 hours (mL)
Fluid16Hrs: Fluid in next 16 hours (mL)

分步指南

1Total 24h = 4 mL × Weight(kg) × %TBSA burned
2First 8h from burn: 50% of total
3Next 16h: 50% of total
4TBSA = Total Body Surface Area burned

例题解析

输入

80 kg patient, 30% TBSA burn

结果

Total = 9,600 mL; 4,800 mL over first 8h (600 mL/h)

常见问题

What's the Rule of 9s for %TBSA?

Head/neck: 9%, Each arm: 9%, Chest: 18%, Abdomen: 18%, Each leg: 18%, Perineum: 1%. Measure by body part involvement. Children differ (head 18%, leg 14%).

Why Lactated Ringers (LR) vs normal saline?

LR isotonic, contains potassium, more physiologic. NS can cause hyperchloremic acidosis. LR preferred in burn resuscitation (evidence-based). Monitor urine output (goal 0.5 mL/kg/hr adults).

Is Parkland formula always enough?

Starting point; adjust based on clinical response. Goal: urine output 0.5 mL/kg/hr (1 mL/kg/hr if inhalation injury). May need more in lightning strike, electrical burns. Serial labs essential.

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