Most effective fluid in Rx of burns is:
a. As burns approach 20% TBSA, local proinflammatory cytokines enter the circulation and result in a systemic inflammatory response.
b. The microvascular leak, permitting loss of fluid and protein from the intravascular compartment into the extravascular compartment, becomes generalized. Cardiac output decreases as a result of burn shock and myocardial injury.
c. The resulting intense sympathetic response leads to increased systemic vascular resistance and decreased perfusion to the skin and viscera.
d. Decreased flow to the skin may convert a zone of stasis to one of coagulation, thereby increasing the depth of burn.
f. Resuscitation begins by starting intravenous LR solution at a rate of 1000 mL/h in adults and 20 mL/kg per hour in young children.
g. Burn patients requiring intravenous resuscitation (i.e., generally those with burns greater than 20% TBSA. should have a Foley catheter placed and urine output monitored hourly, the goal being 30 mL/h in adults and 1.0 mL/kg per hour in young children.
h. Once the extent of the burn is ascertained, resuscitation should be tailored to the injury using the Parkland formula, as both over and underresuscitation are deleterious.