Effect of smoke inhalation injury on fluid requirement in burn resuscitation

The effect of smoke inhalation injury on fluid requirement was assessed retrospectively. A total of 131 burn patients were classified into two groups: burn patients with smoke inhalation injury (Group IB: 73 patients) and burn patients without inhalation injury (Group B: 58 patients). Fluid resuscitation was commenced according to the Parkland formula and the infusion rate was modified to meet the main resuscitation goal of an hourly urine output of 1.0 to 2.0 ml/kg. Regression analyses were performed on the volume of fluid administered during the initial 24 hours after injury by burn size for each group. The linear equations obtained were Y (ml/kg/24 hrs) = 71.0 + 5.08 x %TBSA (Group IB) and Y = 39.7 + 5.14 x %TBSA (Group B). A substantial effect of inhalation injury on fluid requirement was speculated to be reflected in a y intercept difference of about 30 ml/kg/24 hrs. Thus, an increase in the fluid requirement related to the presence of inhalation injury was found to be independent and additional to burn injury.