Abstract
OBJECTIVES: Over-resuscitation is a formidable complication of burn resuscitation and increased morbidity and mortality. Currently, the Advanced Trauma Life Support recommends using a modified Brooke's formula to minimise its incidence; however, supporting evidence is very limited. We aimed to compare the resuscitative and clinical outcomes between the Parkland and modified Brooke's formulas in patients with burn trauma. METHODS: A retrospective cohort study was conducted through a chart review of patients admitted to the burn unit. The patients were divided into two groups: Group 1 (2017-2019) was resuscitated using Parkland's formula and Group 2 (2020-2022) with modified Brooke's formula. The main outcome measures were mortality rate, length of stay, complication rate exceeding the Ivy index (250 mL/kg) in the first 24 h, and overall fluid administered in the first 24 h. RESULTS: We included 125 patients, of whom fifty-five were resuscitated using Parkland's formula and seventy using the modified Brooke's formula. Patients in group 1 had higher resuscitation volume (5.04 vs. 3.37 mL/kg/total body surface area, P < 0.0001) and were more likely to exceed the Ivy index (250 mL/kg) (32.73% vs. 12.86%, P = 0.0074) in the first 24 h compared to those in group 2. There were no significant differences in clinical outcomes between the two groups. CONCLUSIONS: The modified Brooke's formula resulted in lower resuscitative volumes in the first 24 h than Parkland's formula, with no differences in complication rates. Our findings are consistent with currently recommended guidelines.