Am Fam Physician. 2025;112(2):219-220
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
- Fluid resuscitation should be initiated at 2 mL/kg per %TBSA during the first 24 hours, rather than 4 mL/kg per %TBSA, to reduce fluid overload and edema-related complications.
- Albumin infusion should be considered in the first 24 hours of fluid resuscitation as an adjunct treatment in patients with larger burns to improve urine output and minimize total volume of resuscitation fluids.
- Resuscitation should be titrated by urine output instead of invasive or semi-invasive monitoring.
- The use of computerized decision support software in burn resuscitation should be considered, although it is not a substitute for ongoing patient assessment and critical decision-making
From the AFP Editors
Providing intravenous fluids to prevent burn shock is challenging in the first 48 hours following an acute burn injury in adults with burns covering 20% or more of their total body surface area (TBSA). Intravascular fluid depletion from insufficient resuscitation can lead to organ failure and death; however, fluid resuscitation may increase local and pulmonary edema, which can increase morbidity and mortality. The American Burn Association (ABA) has published guidelines on the management of resuscitation to prevent burn shock in patients with significant burns.
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