The Modified Brooke formula for burns is a guideline used to estimate the fluid resuscitation needs for burn patients in the first 24 hours after the burn.
The Modified Brooke Formula
The Modified Brooke formula focuses on colloid administration and limits crystalloid use. Here's the breakdown for the first 24 hours post-burn:
- Colloids: Administer 0.3–0.5 ml/kg/% burn
- Crystalloids: Not given during this period.
- Glucose in Water: Add glucose in water as needed to maintain adequate urinary output.
Example:
Let's say you have a 70 kg patient with a 50% total body surface area (TBSA) burn.
- Colloid Calculation (using a midpoint of 0.4 ml/kg/% burn): 0.4 ml/kg/% burn 70 kg 50% = 1400 ml of colloid in the first 24 hours.
Important Considerations:
- Urinary Output: Monitor urinary output closely and adjust fluid administration accordingly. Adequate urinary output is a key indicator of successful resuscitation.
- Individualization: The Brooke formula is a guideline, and fluid resuscitation should be tailored to the individual patient's needs. Factors such as age, pre-existing conditions, and the depth and location of the burn can all affect fluid requirements.
- Colloid Type: Albumin is a commonly used colloid for burn resuscitation.
- Progression: The provided details only pertain to the first 24 hours. Fluid management will change in subsequent days.
- Titration: Fluid administration should be carefully titrated based on the patient's response, as indicated by urine output, vital signs, and overall clinical condition. Over-resuscitation can be as harmful as under-resuscitation.
The original Brooke formula used crystalloid solutions, but the modified version emphasizes colloids and limits crystalloid use in the initial resuscitation phase.
