Freiburg C, Igneri P, Sartorelli K, Rogers F, et al.
Journal of burn care & research : official publication of the American Burn Association. Date of publication 2007 Jan 1;volume 28(1):42-8.
1. J Burn Care Res. 2007 Jan-Feb;28(1):42-8.
Effects of differences in percent total body surface area estimation on fluid
resuscitation of transferred burn patients.
Freiburg C(1), Igneri P, Sartorelli K, Rogers F.
Author information:
(1)From The University of Vermont College of Medicine, Fletcher Allen Health
Care, Burlington, Vermont 05401-1429, USA.
We sought to analyze the effect that differences in estimation of burn size and
burn resuscitation had on complications and death among our transferred burn
patients, in comparison with outcomes for burn patients directly admitted to our
rural Level 1 trauma center. A retrospective chart review was performed for all
patients suffering thermal injuries who were treated at a rural Level I trauma
center and regional burn center. Percent TBSA burn estimates at referring
hospitals were compared to burn center estimates. The Parkland formula was used
to calculate the difference between the theoretical and actual resuscitation
volumes given prior to admission. Of 127 burn patients, 82 (65%) were transferred
from outside hospitals. For small burns (<20% TBSA), the mean estimate difference
between outside hospitals and the burn center was 4.3 +/- 6.9%. For large burns
(> or =20% TBSA), the mean estimate difference was -4.9 +/- 9.1% (P < .0002). The
mean difference in intravenous fluid administered prior to admission to the burn
center and the Parkland formula guideline was an excess of 554 +/- 1099 ml for
small burns and a deficit of -414 +/- 2081 ml for larger burns (P = .03,
Wilcoxon's rank-sum test). Differences in burn estimation and deviation from the
Parkland formula were not statistically significant for complication and death.
In the rural, transferred burn patient, smaller burns tended to be overestimated
and overresuscitated and larger burns tended to be underestimated and
underresuscitated.
DOI: 10.1097/BCR.0B013E31802C88B2
PMID: 17211199 [Indexed for MEDLINE]
