A 25-year-old burn patient sustains 45% TBSA deep dermal burns (excluding perineum and face). According to the Modified Brooke formula, what is the fluid resuscitation volume in the first 24 hours? The patient weighs 70 kg.
- A 6,300 mL (Ringer's lactate); titrated to urine output 0.5 mL/kg/hr
- B 12,600 mL (0.9% normal saline); half in first 8 hours, then switch to colloid
- C 12,600 mL (Ringer's lactate); half in first 8 hours from time of burn, half in next 16 hours ✓
- D 15,750 mL (Ringer's lactate) using Parkland formula; half in first 8 hours from presentation
Explanation
The Modified Brooke formula calculates 2 mL/kg/%TBSA burn = 2 × 70 × 45 = 6,300 mL in the first 24 hours — given as Ringer's lactate with no colloid in the first 24 hours. The Parkland formula uses 4 mL/kg/%TBSA = 4 × 70 × 45 = 12,600 mL. The question specifies Brooke modified, which is 2 mL/kg/%TBSA. In both formulae, half the volume is given in the first 8 hours from the TIME OF BURN (not time of presentation), and the remaining half over the next 16 hours. Urine output target is 0.5-1 mL/kg/hr in adults. Normal saline is avoided due to hyperchloraemic acidosis risk with large volumes.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.