Does Ringer Lactate Used in Parkland Formula for Burn Resuscitation Adequately Restore Body Electrolytes and Proteins?

Abstract

Objective: Evaluation of the effect of Ringer Lactate, as the resuscitative burn fluid according to Parkland Formula, on restoring the levels of body electrolytes and proteins. Design: A retrospective cohort study. Setting: The National Burns Unit, Mafraq Hospital, Abu Dhabi, United Arab Emirates (UAE). Patients: One hundred and fifteen patients admitted with fresh burns between 1st of January 2011 and 31st of December 2013, who met inclusion and exclusion criteria. Methods: Team collected demographic and clinical data for each patient using a standard form. Patients received Ringer Lactate solely as the resuscitative burn fluid according to Parkland Formula. Baseline (pre-) and third-day (post-) variables included levels of sodium, potassium, chloride, proteins, and albumin. Researchers then performed paired comparisons of serum electrolytes and protein levels. Results: Mean values showed maintenance of the potassium and chloride levels within the normal range after administering the Ringer Lactate, significant decline in sodium, and a marked hypoproteinaemia and hypoalbuminaemia post-resuscitation. Conclusions: Ringer Lactate used as the mere resuscitative post burn fluid is suboptimal. Sodium supplementation may be required to correct hyponatremia. Colloids, preferably intravenous albumin should be added, as advised by the original Parkland Formula.

Mathematical model of volume kinetics and renal function after burn injury and resuscitation

“…3(c)) [1], [14]. It also predicted that sodium concentration decreased after burn injury and resuscitation, which is also consistent with the findings in the literature [45] (Fig. 3(h)).…”

Mathematical Modeling, In-Human Evaluation and Analysis of Volume Kinetics and Kidney Function After Burn Injury and Resuscitation

“…4(f)) [49]; and (v) sodium concentration decreased after burn injury and resuscitation (Fig. 4(h)) [50].…”

Medical and Surgical Care of Critical Burn Patients: A Comprehensive Review of Current Evidence and Practice

“…Ringer’s lactate (RL) is a balanced salt solution and does not cause metabolic acidosis. However, RL has a lower sodium concentration (130 mmol/L) than plasma, and can potentially result in the development of hyponatraemia, especially in patients with stress-induced elevated anti-diuretic hormone levels [ 17 ]. Newer balanced crystalloids have a sodium concentration closer to that of plasma and do not cause hyponatraemia.…”