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This is an interesting well written retrospective analysis of resuscitation in bariatric patients, but the study has two significant flaws. The first flaw is that parkland’s formula, with estimate from lund browder charts is a guide and a best estimate to get resuscitation started but once started it is important to assess other parameters for fluid rate of resuscitation, which would highlight under resuscitation and need for increased fluid delivery. Therefore, over or underestimate of a burn should never be clinically significant if the patient is monitored properly. The second flaw, as with most single centre studies in the UK, patient numbers are weak and no significant conclusion is drawn but this could be related to the number of patients and could be significant in a higher power study. Again, they showed no increased complications or mortality in obese patients, but numbers as stated were very small.  

The value of bariatric specific chart to initiate resuscitation of adult bariatric burns. 
Yim GH, Pujji OJS, Bharj IS, et al. 
BURNS 
2019;45(8):1783-91.
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Bernard Robertson

NHS Lothian; Honorary Senior Clinical Teacher, University of Dundee; PLASTA Examination Representative.

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