Clinical Medicine & Physiology
Galveston Pediatric Burn Resuscitation Formula: 5,000 mL/m^2 Burned + 2,000 mL/m^2 Maintenance
Calculate 24-hour pediatric burn fluid resuscitation and hourly infusion rates using Shriners Burns Institute’s (Carvajal, 1988) BSA-based Galveston Formula: V_24 = 5000 * BSA_m2 * (%TBSA / 100) + 2000 * BSA_m2 (50% in first 8 hours, 50% in next 16 hours).
Why infants have high surface-area-to-weight ratios that make weight-only burn formulas under-resuscitate!
Young children and infants possess a much larger Body Surface Area per kilogram of body mass than adults AND rapidly deplete hepatic glycogen stores during thermal stress! Developed by Hugo F. Carvajal at Shriners Hospitals for Children in Galveston, Texas, the Galveston Pediatric Burn Formula indexes BOTH evaporative/capillary burn losses and basal maintenance directly to Body Surface Area BSA (m^2, e.g. Mosteller SQRT(Height_cm * Weight_kg / 3600)) using Lactated Ringer’s with 5% Dextrose (and albumin supplementation per burn-center protocol):
Total 24-Hour Fluid Volume V_24 (mL) = 5,000 * BSA_burned + 2,000 * BSA_total = BSA_m2 * (5,000 * (%TBSA / 100) + 2,000)! Exactly HALF of V_24 is infused over the First 8 Hours from the time of burn injury (Rate_1_8 = (0.5 * V_24) / 8 mL/hr), and the remaining HALF is infused over the Next 16 Hours (Rate_9_24 = (0.5 * V_24) / 16 mL/hr), titrated continuously to pediatric urine output >= 1.0 mL/kg/hr!
| Galveston Component (Child: 110 cm, 20 kg -> BSA = 0.7817 m^2, 30% TBSA Burn) | Formula | Evaluated Volume / Rate |
|---|---|---|
| Mosteller Total BSA (m^2) | SQRT(110 * 20 / 3600) | 0.7817 m^2 |
| Burn-Loss Resuscitation Term | 5,000 * 0.7817 * 0.30 | 1,172.6 mL |
| Basal BSA Maintenance Term | 2,000 * 0.7817 | 1,563.5 mL |
| Total 24-Hr Fluid | First 8-Hr Rate | V_24 = 2,736 mL | (0.5 * V_24) / 8 | 2,736 mL | 171.0 mL/hr |
Galveston Total 24-Hour Pediatric Burn Fluid + Maintenance Volume V_24 (mL)
Computes Mosteller BSA = SQRT(Height_cm * Weight_kg / 3600) from Height B2 (cm) and Weight B3 (kg) and evaluates BSA * (5000 * (TBSA% / 100) + 2000) for %TBSA B4 (10%–95%).
=IF(OR(B2 < 45, B2 > 190, B3 < 3, B3 > 100, B4 < 10, B4 > 95), "Requires Pediatric Height, Weight, and Resuscitation Burn 10%–95% TBSA", ROUND(SQRT((B2 * B3) / 3600) * (5000 * (B4 / 100) + 2000), 0))First 8-Hour Hourly Infusion Rate (mL/hr from Time of Injury)
Delivers 50% of total 24-hour Galveston volume evenly across the initial 8 post-burn hours (assuming 0 hours elapsed).
=IF(OR(B2 < 45, B2 > 190, B3 < 3, B3 > 100, B4 < 10, B4 > 95), "Requires Pediatric Height, Weight, and Resuscitation Burn 10%–95% TBSA", ROUND((0.5 * SQRT((B2 * B3) / 3600) * (5000 * (B4 / 100) + 2000)) / 8, 1))Try the example
Use the original values or change them to test your understanding.