CBM Fluid Resuscitation & Management 2 — Questions and Answers
Question 1: In the Parkland formula, what percentage of the calculated 24-hour fluid volume should be administered in the first 8 hours post-burn?
- 25%
- 50% (Correct answer)
- 75%
- 100%
Correct answer: 50%
The Parkland formula dictates that 50% of the total 24-hour fluid volume is given in the first 8 hours, with the remaining 50% over the next 16 hours.
Question 2: Which colloid is most commonly used after the first 24 hours of burn resuscitation to help maintain oncotic pressure?
- Dextran 70
- Fresh frozen plasma
- Albumin (Correct answer)
- Hetastarch
Correct answer: Albumin
Albumin is the most commonly used colloid added after 24 hours to restore oncotic pressure and reduce overall fluid requirements.
Question 3: What urine output target per hour is typically used to guide adequate fluid resuscitation in adult burn patients?
- 10–20 mL/hr
- 30–50 mL/hr (Correct answer)
- 75–100 mL/hr
- 100–150 mL/hr
Correct answer: 30–50 mL/hr
A urine output of 0.5 mL/kg/hr, roughly 30–50 mL/hr in adults, indicates adequate renal perfusion and guides resuscitation titration.
Question 4: Fluid creep in burn resuscitation refers to:
- Slow absorption of topical fluids into the wound
- Administration of volumes exceeding formula recommendations, causing complications (Correct answer)
- Gradual redistribution of edema fluid after 48 hours
- Insensible fluid losses from evaporation over open wounds
Correct answer: Administration of volumes exceeding formula recommendations, causing complications
Fluid creep describes the phenomenon of giving far more fluid than resuscitation formulas predict, leading to abdominal compartment syndrome, pulmonary edema, and other complications.
Question 5: In a patient with an electrical burn and myoglobinuria, the urine output goal is adjusted to:
- 10–20 mL/hr
- 30–50 mL/hr
- 75–100 mL/hr (Correct answer)
- 150–200 mL/hr
Correct answer: 75–100 mL/hr
Myoglobinuria requires higher urine output (75–100 mL/hr) to flush myoglobin and prevent acute tubular necrosis.
Question 6: The Modified Brooke formula differs from the Parkland formula primarily in that it:
- Uses hypertonic saline instead of lactated Ringer's
- Recommends a lower initial crystalloid volume of 2 mL/kg/%TBSA (Correct answer)
- Adds colloid in the first 8 hours
- Calculates fluid needs based on weight alone
Correct answer: Recommends a lower initial crystalloid volume of 2 mL/kg/%TBSA
The Modified Brooke formula uses 2 mL/kg/%TBSA of lactated Ringer's in the first 24 hours, compared to the Parkland formula's 4 mL/kg/%TBSA.
Question 7: Which complication is most directly associated with excessive fluid resuscitation (fluid creep) in burn patients?
- Hypernatremia
- Abdominal compartment syndrome (Correct answer)
- Hypoglycemia
- Acute respiratory alkalosis
Correct answer: Abdominal compartment syndrome
Over-resuscitation leads to massive tissue edema, which can cause abdominal compartment syndrome, a life-threatening increase in intra-abdominal pressure.
CBM Fluid Resuscitation & Management 2
In the Parkland formula, what percentage of the calculated 24-hour fluid volume should be administered in the first 8 hours post-burn?