In a 70 kg adult with 40% TBSA burn, using Parkland formula, how much lactated Ringer's should be given in the first 8 hours and what is the urine output target?

• A. Lactated Ringer's 11,200 mL in 24 hours; 5,600 mL in the first 8 hours; urine output 0.5–1 mL/kg/h
• B. Lactated Ringer's 8,000 mL in 24 hours; 3,000 mL in the first 8 hours; urine output 0.25–0.5 mL/kg/h
• C. Lactated Ringer's 14,000 mL in 24 hours; 7,000 mL in the first 8 hours; urine output 1–2 mL/kg/h
• D. Lactated Ringer's 11,200 mL in 24 hours; 6,000 mL in the first 8 hours; urine output target 0.5–1 mL/kg/h

Answer: (A)

The key idea is fluid resuscitation using the Parkland formula: give 4 mL of lactated Ringer's per kilogram of body weight for each percent of TBSA burned in the first 24 hours, with half delivered in the first 8 hours and the remainder over the next 16 hours. For a 70 kg adult with 40% TBSA burn, that’s 4 × 70 × 40 = 11,200 mL in the first 24 hours. Half of that should be given in the first 8 hours, which is 5,600 mL. The urine output target for adults is 0.5–1 mL/kg/hour, so for a 70 kg patient that’s 35–70 mL/hour. That matches the option stating 11,200 mL in 24 hours, 5,600 mL in the first 8 hours, and urine output of 0.5–1 mL/kg/h.