Journal Review in Burn Surgery: Fluid Resuscitation

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 4 August 2025

⏱️ 23 minutes

🔗️ Recording | iTunes | RSS

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Summary

You’re on call at a level I trauma center and you get called that you’re receiving a large TBSA burn patient – you’re not working at a burn center! You remember hearing about some controversy surrounding burn resuscitation – was it the parkland formula? Consensus formula? ABSITE asked about the Modified Brooke Formula?!? Join Dr. Kathleen Romanowski, Dr. Laura Johnson, Dr. Victoria Miles, and Dr. Lauren Nosanov to discuss modern burn fluid resuscitation!

Hosts:
· Kathleen Romanowski – University of California Davis Hospital, Shriners Hospital Sacramento
· Laura Johnson – Grady Memorial Hospital
· Lauren Nosanov – Grady Memorial Hospital
· Victoria Miles – Louisiana State University Health Science Center, University Medical Center New Orleans

Learning Objectives:
· Review the basics of initial burn fluid resuscitation
· Evaluate the literature informing national burn fluid resuscitation guidelines
· Consider the causes of failed burn resuscitation and strategies for identifying these complications

References:
· Pham TN, Cancio LC, Gibran NS. American Burn Association Practice Guidelines Burn Shock Resuscitation. J Burn Care Res. 2008: 257-266. doi:10.1097/jbcr.0b013e31815f3876. https://pubmed.ncbi.nlm.nih.gov/18182930/
· Rizzo JA, Coates EC, Serio-Melvin ML, et al. Higher Initial Formula for Resuscitation After Severe Burn Injury Means Higher 24-Hour Volumes. J Burn Care Res. 2023:1017-1022. doi:10.1093/jbcr/irad065. https://pubmed.ncbi.nlm.nih.gov/37339255/

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Transcript

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0:00.0	Behind the Knife.
0:23.6	Today we're doing a journal review in burn fluid resuscitation.
0:27.6	This is our first burn dedicated episode with our new bird team and we're excited.
0:32.6	So you're on call at a level one trauma center and you get called that you're receiving a large TBSA burn patient.
0:39.9	You're not working at a burn center.
0:42.0	You remember hearing about some controversy
0:44.2	surrounding burn resuscitation.
0:46.0	Was it the Parkland formula, consensus formula?
0:50.2	You think you remember that Abside asked about the modified brook
0:52.9	formula.
0:53.9	So join Dr. Kathleen Romano Romanowski, Dr. Laura Johnson, myself, and Dr. Lauren Nassanov to discuss modern burn fluid resuscitation.
1:04.3	So, welcome, ladies.
1:06.4	I thought we'd get started today with this case.
1:09.8	You have a 35-year-old male who presents to the trauma bay of your level one trauma center after a welding accident,
1:17.6	during which is clothing caught fire.
1:19.6	EMS reports the patient has sustained a 40 to 60 percent TBSA burn, total body surface area.
1:26.6	Vital signs are heart rate of 130, blood pressure 150 over 96, sat of 92% on two
1:33.7	liters nasal cannula.
1:35.4	Dr. Nassanov, what are your first thoughts?
1:38.8	So I have a lot of first thoughts, but the first thing I really want to know is was their associated trauma? Was he an enclosed space?
1:48.3	Why do you ask? Well, whether or not the patient has associated trauma totally changes my course of
1:54.0	management. Trauma's always going to come first. Burn patients are first a trauma patient, and I'm not just saying that because we're not in a
	...

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