Fluid therapy in burns.

Most published accounts of fluid therapy for burns emphasize the advantages of the regime favoured by that author and give details of the scientific evidence for its superiority over all other regimes. Directly, or by implication, alternative methods are condemned or ignored. Clearly this is quite ridiculous because all the well recognized schemes of resuscitation have been validated in clinical practice. The obvious and important differences in these schemes must, therefore, be related to clinical events other than the prevention of burn shock. However, so varied are the regimes in common use, and so apparently contradictory the statements made in suppport of them, that anyone could be forgiven for concluding that they share no common ground. The main objective of this paper is to show that all regimes of effective fluid therapy in burns are based on certain well established principles and that a common ground of therapy does exist. The secondary objectives are to indicate why particular regimes have become favoured in particular localities and why the random choice of a regime is likely to be dangerous.