Parkland formula

The Parkland formula, also known as Baxter formula, is a burn formula developed by Dr. Charles R. Baxter, used to estimate the amount of replacement fluid required for the first 24 hours in a burn patient so as to ensure the patient is hemodynamically stable.[1][2][3] The milliliter amount of fluid required for the first 24 hours – usually Lactated Ringer's – is four times the product of the body weight and the burn percentage (i.e. body surface area affected by burns).[4] The first half of the fluid is given within 8 hours from the burn incident, and the remaining over the next 16 hours. Only area covered by second-degree burns or greater is taken into consideration, as first-degree burns do not cause hemodynamically significant fluid shift to warrant fluid replacement.[5]

The Parkland formula is mathematically expressed as:[4]

where mass (m) is in kilograms (kg), area (A) as a percentage of total body surface area, and volume (V) is in milliliters (mL). For example, a person weighing 75 kg with burns to 20% of his or her body surface area would require 4 x 75 x 20 = 6,000 mL of fluid replacement within 24 hours. The first half of this amount is delivered within 8 hours from the burn incident, and the remaining fluid is delivered in the next 16 hours.[6]

The burn percentage in adults can be estimated by applying the Wallace rule of nines (see total body surface area): 9% for each arm, 18% for each leg, 18% for the front of the torso, 18% for the back of the torso, and 9% for the head and 1% for the perineum.[7]

See also

References

  1. Brunicardi, F. Charles (2014). Schwartz's Principles of Surgery. 1 (10th ed.). McGraw-Hill Education. p. 230. ISBN 978-0-07-180092-1.
  2. Mitchell, Katrina; et al. (1 Aug 2014). "New management strategy for fluid resuscitation: Quantifying volume in the first 48 hours after burn injury". J Burn Care Res. 34 (1): 196–202. doi:10.1097/BCR.0b013e3182700965. PMC 4118491. PMID 23292589.
  3. "Surgical Treatment of Burns : Treatment and management". MedScape. Retrieved 29 August 2012.
  4. Sunny, Joseph. "Parkland formula". MedSoft. Retrieved 29 August 2012.
  5. "Surgical Treatment of Burns Treatment & Management". Surgical Treatment of Burns Treatment & Management. May 15, 2014. Retrieved June 17, 2014.
  6. "Parkland's formula for emergency fluid management". Emergency Medicine. Retrieved 29 August 2012.
  7. "MD+Calc: Parkland Formula for Burns". Retrieved 18 December 2012.

Further reading

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