[Intensive care of patients with burns]

We discuss the fluid requirements of burn patients and present the most common formulas for fluid resuscitation. The most commonly used formula is the Parkland formula containing 4 ml/kg/% Ringer acetate, which we still recommend for general use. Hypertonic Ringer acetate containing 240 mmol Na/l may reduce fluid requirement and edema generation. Regardless of formula applied, the fluid therapy is adjusted to individual requirements. We discuss nutritional demands and monitoring of nutritional status, and propose individual treatment based on weight development and nitrogen balance studies. We also consider upper and lower airway injuries, with emphasis on early diagnosis and treatment. We stress the need for prophylactic intubation before the upper airways become obstructed. Prophylactic use of steroids and antibiotics is not indicated after inhalation of smoke causing pulmonary injury. Prolonged nasal intubation gives less severe sequelae than tracheostomy.