CBM Fluid Resuscitation & Management 3

Question 1

For pediatric burn patients, the Galveston formula adds maintenance fluids to the resuscitation calculation. What is the maintenance component?

Accepted Answer

2,000 mL/m² body surface area/day

Answer

The Galveston formula adds 2,000 mL/m² total BSA for maintenance to account for the higher surface-area-to-volume ratio and metabolic needs in children.

Question 2

Hypertonic saline resuscitation in burn patients is theorized to reduce total fluid volume by:

Accepted Answer

Drawing interstitial fluid into the intravascular space via osmotic gradient

Answer

Hypertonic saline creates an osmotic gradient that draws fluid from the interstitium into the vasculature, theoretically reducing total resuscitation volumes.

Question 3

During the emergent phase of a major burn, capillary leak is most pronounced within the first:

Accepted Answer

18–24 hours

Answer

Capillary permeability peaks within the first 18–24 hours post-burn before gradually normalizing, which is why aggressive crystalloid resuscitation is prioritized early.

Question 4

What is the primary reason lactated Ringer's solution is preferred over normal saline for burn resuscitation?

Accepted Answer

It avoids hyperchloremic metabolic acidosis associated with large volumes of normal saline

Answer

Large volumes of normal saline cause hyperchloremic metabolic acidosis; lactated Ringer's is more physiologically balanced and avoids this complication.

Question 5

Which hemodynamic parameter, when used with goal-directed therapy, helps avoid both under- and over-resuscitation in burn patients?

Accepted Answer

Stroke volume variation (SVV) monitored continuously

Answer

Stroke volume variation (SVV) via invasive monitoring provides dynamic preload responsiveness data, enabling more precise fluid titration than static parameters like CVP.

(CBM) Certified Burn Manager Practice Test

(CBM) Certified Burn Manager Practice Test

CBM Fluid Resuscitation & Management 3