Effectiveness of burns resuscitation using two different formulae

Prior to 1989 burns were resuscitated at the Burns Unit Frenchay Hospital according to the Mount Vernon formula. In 1989 a 33 per cent modification was introduced as suggested by Watson, Walker and Sanders. The aim of this study was to examine retrospectively the effects of the resuscitation protocols on morbidity and mortality. The total numbers of burns admitted to Frenchay in 1988 were 93 adults and 58 children. This compares with 82 adults and 55 children admitted in 1989. Of these, approximately one-fifth required intravenous resuscitation. No statistical difference was found between the two groups for age, body weight, distribution of burn, or delay in arriving at the burns unit (taken from the time of burn). In both years the volume of albumin used in resuscitation exceeded the calculated requirement after the third period (P less than 0.05). The 1989 patients were transfused with greater volumes, resulting in increased urine output (P less than 0.001). No difference in morbidity or mortality was shown. However, the investigation did show that the 1989 patients achieved urine outputs indicative of overtransfusion. It is concluded that the Watson-Walker modification is unnecessary and possibly undesirable.