What is the main goal of therapy for fluid resuscitation in burn patients?

• A. 0.5 to 1.0 mL/kg/hour of urine output
• B. MAP > 70 mmHg
• C. Lactate normalization within 2 hours
• D. Urine output 0.2-0.5 mL/kg/hour

Answer: (A)

In burn resuscitation, the most useful, real-time indicator of adequate fluid therapy is urine output, because it directly reflects kidney perfusion and overall circulating volume. For adults, aiming for about 0.5 to 1 mL per kilogram per hour provides a practical target that links fluid administration to organ perfusion. If urine output falls below this range, it signals under-resuscitation and fluids should be increased; if it stays consistently high, fluids can be slowed or stopped to avoid overload. While maintaining a perfusion pressure (MAP) is important, it’s not as sensitive a marker for guiding fluid therapy on its own, and lactate normalization is not a reliable early endpoint in the acute resuscitation phase. The lower urine output range (0.2–0.5 mL/kg/hr) would indicate insufficient resuscitation.