A burn patient has urine output of 230 mL in the past 4 hours. What action should be taken with the IV fluid rate?

A burn patient has urine output of 230 mL in the past 4 hours. What action should be taken with the IV fluid rate?

• A. Increase the rate by 25%
• B. Decrease the rate by 25%
• C. No change to the rate
• D. Decrease the rate by 50%

Answer: (B)

In burn resuscitation, urine output is the real-time gauge of whether fluid therapy is appropriately titrated. The target for adults is about 0.5 mL/kg per hour. Here, 230 mL over 4 hours is 57.5 mL per hour, which exceeds the typical target. That suggests you’re over-resuscitating, so you should scale back the IV fluid rate to bring urine output back toward the goal. Reducing the rate by about 25% is a safe, moderate adjustment to lower the fluid administration without risking sudden under-resuscitation. After making this change, continue to monitor urine output hourly and reassess perfusion signs (blood pressure, heart rate, mental status, skin findings, edema). If urine output remains above target, you can reduce further; if it drops toward or below target, consider adjusting back or stabilizing near the goal. Avoid large, abrupt changes and never ignore signs of inadequate perfusion.

In burn resuscitation, urine output is the real-time gauge of whether fluid therapy is appropriately titrated. The target for adults is about 0.5 mL/kg per hour. Here, 230 mL over 4 hours is 57.5 mL per hour, which exceeds the typical target. That suggests you’re over-resuscitating, so you should scale back the IV fluid rate to bring urine output back toward the goal.

Reducing the rate by about 25% is a safe, moderate adjustment to lower the fluid administration without risking sudden under-resuscitation. After making this change, continue to monitor urine output hourly and reassess perfusion signs (blood pressure, heart rate, mental status, skin findings, edema). If urine output remains above target, you can reduce further; if it drops toward or below target, consider adjusting back or stabilizing near the goal. Avoid large, abrupt changes and never ignore signs of inadequate perfusion.