Burns: Fluid Creep

The podcast reviews Dr. Jeff Saffel's article in the Journal of Burn Care and Rehab, which addresses fluid creep and acute burn resuscitation. It traces the evolution of burn resuscitation from the World War II era to the present day, highlighting the development and subsequent modifications of the Parkland formula. The discussion emphasizes that modern burn care often involves fluid volumes exceeding Parkland predictions, leading to complications like edema and abdominal compartment syndrome. The podcast explores reasons for fluid creep, including the underutilization of colloids, variations in burn center practices, and the potential pitfalls of goal-directed resuscitation using PA catheters. It advocates for a balanced approach, suggesting restricted early fluid resuscitation, judicious use of colloids, and adherence to resuscitation protocols to avoid over-resuscitation and its associated complications.