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Updated: Jun 17, 2026
16:31
Fixed Volume or Fixed Pressure: A Murine Model of Hemorrhagic Shock
Published on: June 6, 2011
Colloid administration normalizes resuscitation ratio and ameliorates "fluid creep"
Amanda Lawrence1, Iris Faraklas, Holly Watkins
1Burn Trauma ICU, Department of Surgery, University of Utah College of Medicine, Salt Lake City, Utah, USA.
Summary
Colloid (albumin) supplementation effectively manages "fluid creep" in burn resuscitation, rapidly normalizing fluid requirements and restoring normal resuscitation ratios when crystalloid alone is insufficient. This approach aids in selective, algorithm-based treatment.
Area of Science:
- Burn resuscitation
- Trauma critical care
- Fluid management
Background:
- The Parkland formula, a standard for burn resuscitation, has omitted colloid for decades.
- Some centers utilize colloid as rescue therapy for escalating crystalloid needs, termed 'fluid creep'.
Purpose of the Study:
- To evaluate the efficacy of albumin supplementation in burn patients experiencing fluid creep.
- To assess the impact of colloid on fluid resuscitation ratios and requirements.
Main Methods:
- Retrospective review of adult burn patients (>20% TBSA) from 2005-2007.
- Patients were resuscitated with Parkland formula, with albumin added for excessive fluid requirements.
- Fluid infusion to urine output (I/O) ratios were tracked hourly.
Main Results:
- Twenty-six patients required albumin supplementation (AR), comparable to 26 on crystalloid alone.
- AR patients showed progressively increasing I/O ratios (max mean 1.97) before albumin.
- Albumin administration rapidly normalized I/O ratios to predicted ranges.
Conclusions:
- Hourly I/O ratios effectively monitor fluid resuscitation.
- Adding colloid (albumin) to Parkland resuscitation quickly reduces fluid needs and resolves fluid creep.
- Selective colloid use, guided by algorithms, is a viable strategy for managing complex burn resuscitation.
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