10. Appendix
CARVAJAL-GAVLESTON FORMULA
- First 24 hours:
- 5,000 mL x BBSA (m2) + 2,000 mL x TBSA (m2)*
- Ringer's lactate (half in the first 8 hours and the rest in the following 16 hours). No colloid should be given.
- Second 24 hours:
- 3,750 mL x BBSA (m2) + 1,500 mL x TBSA (m2) of dextrose solutions with electrolytes (based on patient's electrolytic anomalies)
*BBSA (burned body surface area): Formula: TBSA x %/100
**TBSA (total body surface area): Formula: (W (kg) x H (cm)/3600)
Notes:
Colloids are recommended at least 12-24 hours after the burn, using albumin poor in salt 1 g/kg/day divided in 3 doses (this aims at maintaining albumin levels above 2.4 g/dL).
If the patient develops myoglobinuria or hemoglobinuria (electrical burns, for example), take the following steps:
- increase fluids administered to achieve a urine output of 3-5 ml/kg/hour
- add bicarbonate to solutions
- if urine output does not improve, add mannitol to therapy