What is the best indicator of adequate fluid resuscitation in burn patients?

Adequate urinary output is considered the best indicator of adequate fluid resuscitation in burn patients. In the context of burns, especially severe ones, fluid loss can be significant due to increased capillary permeability and evaporation from the injured skin. Monitoring urinary output allows clinicians to assess renal perfusion and overall circulatory status, which are critical after significant fluid losses.

A urine output of at least 0.5 to 1.0 mL/kg/hour is often targeted in burn patients as it reflects sufficient kidney perfusion and indicates that the body's systemic blood volume is adequate. If fluid resuscitation is ineffective and perfusion is compromised, the kidneys may not produce urine effectively, leading to oliguria or anuria, which can signal inadequate fluid replacement.

While normal heart rate, central venous pressure, and reversal of systemic acidosis are also important metrics in managing burn injuries, they can be influenced by a variety of other factors and do not provide as direct an assessment of renal perfusion and fluid status as urinary output does. Thus, adequate urinary output remains the primary and most reliable indicator specifically for assessing fluid resuscitation in this patient population.