Parkland-Formel-Rechner
Estimate crystalloid (Lactated Ringer's) fluid requirements for the first 24 hours after a major burn injury.
Eingaben
⚠ Important: The Parkland formula is a starting estimate only. Titrate fluids to clinical endpoints: urine output 0.5–1 mL/kg/hr in adults (1 mL/kg/hr in children). Time starts from the time of burn, not arrival. Subtract any fluids already given.
Disclaimer: Nur zu Bildungszwecken. Kein Ersatz für klinisches Urteilsvermögen.
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What Is the Parkland Formula?
The Parkland formula (also known as the Baxter formula) is the most widely used guideline for initial crystalloid fluid resuscitation in major burn injuries. Developed by Dr. Charles Baxter at Parkland Memorial Hospital in 1968, it calculates the total volume of Lactated Ringer's solution needed in the first 24 hours as: 4 mL × body weight (kg) × %TBSA burned (2nd and 3rd degree only). Half of the calculated volume is administered in the first 8 hours from the time of burn, and the remaining half over the next 16 hours.
When to Use the Parkland Formula
Apply the Parkland formula in patients with significant thermal burns, typically ≥20% TBSA in adults or ≥10% TBSA in children, where IV fluid resuscitation is indicated. It provides a starting estimate for resuscitation — the actual fluid rate must be titrated to clinical endpoints, primarily urine output (0.5–1 mL/kg/hr in adults, 1 mL/kg/hr in children). Time zero is the time of burn injury, not hospital arrival.
Interpreting Parkland Results
The calculated volume is an estimate, not a prescription. Under-resuscitation leads to hypovolemic shock, organ failure, and burn wound conversion. Over-resuscitation (fluid creep) causes edema, abdominal compartment syndrome, extremity compartment syndrome, and ARDS. The goal is to find the minimum fluid rate that maintains adequate organ perfusion. Burns >50% TBSA represent massive burns requiring ICU-level care and aggressive monitoring.
🔑 Klinische Praxistipps
- Only count 2nd-degree (partial thickness) and 3rd-degree (full thickness) burns. First-degree burns (sunburn-like) are excluded from %TBSA calculation.
- Use the Rule of Nines for rapid adult TBSA estimation. For children and irregular burns, use the Lund-Browder chart or the patient's palm (including fingers) as ~1% TBSA.
- Fluid creep is one of the most common and dangerous errors in burn resuscitation. Titrate to urine output — do not simply increase rates because the patient "looks dry."
- Abdominal compartment syndrome can occur with large-volume resuscitation. Monitor bladder pressures in patients receiving >250 mL/kg in 24 hours.
- Inhalation injury increases fluid requirements by approximately 30–40% above Parkland calculations.
- Consider early transfer to a burn center for burns >20% TBSA, full-thickness burns, or involvement of face/hands/feet/genitalia/joints.
Key References
- Baxter CR, Shires T. Physiological response to crystalloid resuscitation of severe burns. Ann N Y Acad Sci. 1968;150(3):874–894.
- Baxter CR. Fluid volume and electrolyte changes in the early post-burn period. Surg Clin North Am. 1978;58(6):1313–1322.
- Saffle JI. The phenomenon of "fluid creep" in acute burn resuscitation. J Burn Care Res. 2007;28(3):382–395.
- ISBI Practice Guidelines for Burn Care. Burns. 2016;42(5):953–1021.
Formel zuletzt überprüft: Februar 2026