Pediatric burn fluid resuscitation (Parkland / modified Brooke)

Pediatric Parkland: 24-h lactated Ringer's = 3 mL x weight(kg) x %TBSA; give half in the first 8 hours (timed from the burn), the rest over the next 16 hours. Pediatric modified Brooke uses the same 3 mL x weight x %TBSA. Holliday-Segar maintenance (children, added on top of resuscitation): 100 mL/kg/day for the first 10 kg, +50 mL/kg/day for each kg from 10-20 kg, +20 mL/kg/day for each kg above 20. Combined 24-h total = pediatric Parkland resuscitation + maintenance. %TBSA counts second- and third-degree burn only (Lund-Browder chart in children).

Therapy/dosing formula, not a severity score — it outputs a STARTING crystalloid volume that is then titrated to urine output, not a risk band; interpretation is intentionally empty. Fluid is lactated Ringer's (LR). Give HALF of the 24-h resuscitation volume in the first 8 hours and the remaining half over the next 16 hours, with the clock started at the TIME OF THE BURN, not arrival — late presentation compresses the remaining first-8-h volume into fewer hours (the rate changes, not the volume). THE CLOCK, AND WHAT THIS CALCULATOR DOES NOT DO WITH IT. Published protocols do two things this tool does not. They anchor time 0 at the injury and then subtract fluid ALREADY GIVEN before dividing what is left over the hours remaining in the 8-hour window — ABRUPT anchored every hourly observation to the burn, recorded a mean 2.9 h (SD 2.6) from burn to burn-centre arrival, and found patients had already received a mean 1553 mL (SD 1782) by then, which is not a rounding matter. This score has no elapsed-time input, no fluid-already-given input, and emits no infusion rate; its first-8-hour figure is simply half the 24-hour volume, measured from the burn. That is a gross volume, not the volume still to be infused, and the subtraction and the division are left to be done by hand. THE 8-H/16-H SPLIT — WHERE IT ACTUALLY COMES FROM, AND A CORRECTION TO WHAT THIS PAGE USED TO SAY. Every version of this page up to and including v1.2.1 stated that the split was absent from the 1968 Baxter & Shires original and derived nowhere. THAT WAS WRONG, and it is corrected here rather than quietly reworded, because a reader who saw the old claim is owed the correction. Baxter & Shires 1968 (Ann N Y Acad Sci 150(3):874-894, DOI 10.1111/j.1749-6632.1968.tb14738.x) has since been READ DIRECTLY FROM THE SOURCE PDF, on 2026-08-03, and p883 states the split explicitly and reports it as what the paper calls 'the optimum response': 16-20% of body weight given in the first eight hours after the burn, at 20 cc/kg/h, then a further 8-10% of body weight as lactated Ringer's, at 5 cc/kg/h, across the next sixteen hours; a figure legend on the same page describes a treatment schedule divided the same way, eight hours and then sixteen. So the split IS in the 1968 original and it IS derived there — experimentally, not by convention, and not from nowhere. WHAT THE DERIVATION ACTUALLY IS, WHICH IS THE PART THAT GOVERNS HOW FAR IT TRAVELS. It is an ANIMAL experiment: dogs, 50% TBSA flame burn, with plasma volume and functional extracellular fluid as the measured endpoints. It is not a human outcome trial, not a randomised comparison of one split against another, and nothing about it is paediatric. Two further things follow from the paper's own figures; they are this project's arithmetic on the doses it prints, not claims the paper makes. (a) Those doses are expressed as PERCENT OF BODY WEIGHT, not as mL/kg/%TBSA, so what 1968 fixes is the two-phase shape of the schedule and not the coefficient this calculator uses. (b) In that canine optimum the first eight hours carried TWICE what the next sixteen carried — 16% against 8%, i.e. two-thirds of the 24-hour volume — whereas clinical practice, and this calculator, give HALF in the first eight hours. The 50/50 halving in universal use is therefore not the ratio the derivation found optimal, and nothing published reconciles the two. AND A THIRD FIGURE, WHICH IS WHAT CLINICIANS ACTUALLY DO — NEITHER HALF NOR TWO-THIRDS. Cartotto 2002 (J Burn Care Rehabil 23(4):258-265, PMID 12142578; abstract and figure captions read on 2026-08-04, full text not accessed) measured 31 adults with burns of 15% TBSA or more: the actual 24-hour volume was 6.7 mL/kg/%TBSA (SD 2.8) and exceeded the Parkland prediction in 84% of them, and at the eight-hour mark the infusion rate DECREASED by 34% in 16 patients while it INCREASED by 47% in 15 (two-way ANOVA, P<0.001). Roughly half the cohort turned the rate down and roughly half turned it up, at magnitudes no fixed fraction implies: the practised shape is patient-dependent titration, not a fraction anybody delivers. Three qualifications travel with that study and none may be dropped — it is ADULT, it is n=31 at a single centre, and it is PRE-WINDOW (2002), so it is not in-window evidence and it licenses nothing paediatric. It is carried because it is the only published measurement of the two phases' behaviour this review located at all, which is itself the finding: see the settled-absent list below. WHY EIGHT HOURS, AND NOT SOME OTHER HOUR. The 1968 paper derives the two-phase schedule but does not enumerate why the boundary falls at eight. A secondary overview attributes it to burn-related myocardial depression recovering at 4-8 hours, while conceding in the same breath that the rationale is not clearly enumerated in the original. That is recorded here as a secondary attribution carrying its own hedge — not as a finding, and not as something Baxter & Shires state. WHAT REMAINS GENUINELY ABSENT, NARROWED TO ITS REAL SCOPE. No human re-derivation of the split exists, no paediatric derivation of it exists at any age, and no guideline states it: the 2024 ABA CPG does not address the split in any of its ten PICO questions, and no source in a 2016-2026 review derives it. THAT residual — the human and paediatric evidence, and the guideline-level statement — is [SETTLED-ABSENT] and is not to be re-searched. The split's origin and its animal derivation are no longer part of it. %TBSA counts second- and third-degree (partial + full thickness) burn only and, in children, must be estimated with the age-adjusted Lund-Browder chart, NOT the Rule of Nines (a child's head is a much larger fraction of BSA). THE LUND-BROWDER CHART, AND ITS SOURCING. The chart now ships as verified data alongside this score: 19 body segments across 6 age bands, per side for paired segments (each cell is one limb, so both hands together are 5% and both adult lower limbs 40%). Its provenance is stated exactly, and fact by fact, because the facts do not share a source. The values are after Lund & Browder (1944), as reproduced in the US Department of Defense Joint Trauma System Burn Care CPG Lund Browder Burn Estimate & Diagram worksheets, and the three dates that go with them — Infant (July 2025), Pediatric (June 2025), Adult (June 2025) — are the individual WORKSHEET dates, not the guideline's. The guideline identifier and its own date, Burn Care CPG ID 12 dated 10 June 2025, come from the JTS CPG index at jts.health.mil and were checked there on 2026-08-03. The 1944 paper itself was NOT obtained (Surgery, Gynecology & Obstetrics vol. 79 is not digitised in any reachable open repository), so this is an attribution to a dated modern reproduction and not a claim on the 1944 original; whether the 19-row tabular layout appears in that form in 1944 is unconfirmed. Age bands are birth to <1, 1 to <5, 5 to <10, 10 to <15, 15 to <16 and 16+ years, so a 3-year-old is scored on the 1-year column and a 7-year-old on the 5-year column. The head falls 19 -> 17 -> 13 -> 11 -> 9 -> 7% with age while the thighs and lower legs take up exactly what the head loses, so every column sums to exactly 100 — which is asserted on every release, because MOST Lund-Browder charts in circulation do not. Lundin & Alsbjorn (Burns 2013;39(4):819-820) traced the common 101% defect to a typographic error that makes one aspect of each hand 1.5% instead of 1.25%, i.e. each hand 3% instead of 2.5%, adding 1.0 to every column; a second, less-documented defect prints half a thigh at age 10 as 4.5 instead of 4.25, making each thigh 9% instead of 8.5% and inflating the 10-14 column alone. This table carries the values that close at 100. Do not use any Lund-Browder chart you have not summed yourself. LIMITATIONS OF THE CHART ITSELF: the anthropometric substrate is roughly a century old — Lund and Browder did not measure these proportions but assembled them from Berkow (1924) and Boyd (1935), behind which sit Du Bois (1915) and Funke (1858) — and none of it has been revalidated against modern population data. The chart was never developed or validated by an expert panel using stringent scientific principles or defined protocols; concurrent validity against computerised planimetry appears high, but its other clinimetric properties are largely unstudied, and Lund and Browder themselves claimed applicability to 95.5% of the population rather than all of it. It does not account for obesity, breast size, pregnancy, or amputated body parts, each of which shifts relative body proportions. Simple erythema (superficial/first-degree burn) is EXCLUDED from %TBSA; the JTS worksheets carry a separate first-degree column explicitly marked not to be added to the total. Inter-rater variability is substantial and grows with burn size — overestimation is the commoner direction of error outside burn centres, and an error either way beyond about 10% is associated with real morbidity. The chart is data here, not an input: %TBSA is still entered as a single number the clinician has already estimated. Pediatric Parkland and pediatric modified Brooke both use 3 mL/kg/%TBSA, so their 24-h volumes converge; the ADULT coefficients differ (Parkland 4 mL, modified Brooke 2 mL) and are NOT emitted here to avoid over-dosing a child. For CHILDREN, Holliday-Segar maintenance fluid — commonly a 5%-dextrose-containing fluid (limited glycogen stores -> hypoglycemia risk) — is added ON TOP of the LR resuscitation volume (adults get no separate maintenance); the surface-area Galveston/Cincinnati formulas instead fold maintenance in but require height/BSA and are not computed here. THE 3 mL PAEDIATRIC COEFFICIENT — AND A WARNING THIS PAGE CARRIED ONE RELEASE AGO, NOW WITHDRAWN. Versions 1.4.0 and 1.5.0 told readers that children may require approximately 6 mL/kg/%TBSA against the 3 this calculator emits, listed it as controversy 9 of nine, gave it its own caution, and named the failure direction as UNDER-resuscitation of small children. THAT FRAMING WAS WRONG. It is retracted here in place rather than quietly reworded, because a reader who saw it was told this calculator might be under-dosing their patient, and that reader is owed the retraction rather than a silently different sentence. THE TWO FIGURES NEVER MEASURED THE SAME QUANTITY. Approximately 6 is a TOTAL 24-hour volume that INCLUDES maintenance; 3 is the RESUSCITATION coefficient alone, to which this score adds Holliday-Segar maintenance separately at every weight it accepts. Comparing them was a category error, not a finding. THE PRIMARY BEHIND THE 6 SAYS SO ITSELF, AND RECOMMENDS PRECISELY WHAT IS IMPLEMENTED HERE. Graves TA, Cioffi WG, McManus WF, Mason AD Jr, Pruitt BA Jr, J Trauma 1988;28(12):1656-9, PMID 3199467, DOI 10.1097/00005373-198812000-00007 (abstract and the publisher abstract page read on 2026-08-04; the full body was NOT opened, so nothing beyond these figures is claimed from it) studied 43 children aged 1.5-108 months with 25-89% TBSB, all weighing 25 kg or less, and reported BOTH numbers from that one cohort: average TOTAL 24-hour fluid 6.3 +/- 2.2 cc/kg/%TBSB, and NET resuscitation fluid — the total MINUS calculated maintenance — 3.91 +/- 2.2 cc/kg/%TBSB. Its recommendation is quoted rather than paraphrased, because it is the clearest possible statement of the point: 'We recommend supplying maintenance volume and initiating burn resuscitation at 3 cc/kg/% TBSB.' Maintenance supplied, resuscitation initiated at 3 — that is this score's structure, coefficient for coefficient, so the finding VINDICATES the design rather than merely tolerating it. Merrell SW et al., Am J Surg 1986;152:664-9, PMID 3789292 (abstract read) corroborates how the larger figure should be read: 177 children, mean burn 27% TBSA, mean TOTAL 24-hour fluid 5.8 +/- 0.25 mL/kg/%TBSA — again a total, again not a resuscitation coefficient. WHY THIS IS A RECONCILIATION AND NOT AN ARITHMETIC COINCIDENCE, WHICH IS THE QUESTION THE PREVIOUS VERSION COULD NOT ANSWER. Maintenance expressed per kilogram per %TBSA is not a constant: it FALLS as weight rises, because the Holliday-Segar tiers step down from 100 to 50 to 20 mL/kg/day while the resuscitation term stays linear in weight. So 3 plus maintenance approximates 6 in a small infant and lands deliberately lower in a larger child. The worked numbers are this project's own arithmetic on the formulas above, not claims any source makes. At 40% TBSA: a 10 kg infant gets 3 + 2.5 = 5.5 mL/kg/%TBSA (maintenance 1000 mL over 10 x 40), a 25 kg child 3 + 1.6 = 4.6 (1600 mL over 25 x 40), and a 60 kg adolescent 3 + about 1.0 = 4.0 (2300 mL over 60 x 40). At 20% TBSA the same sum gives 8.0 mL/kg/%TBSA at 8 kg, 6.2 at 25 kg and 4.9 at 60 kg. THE DECLINE IS THE FEATURE. A flat single figure of 6 applied at every weight would overhydrate the large child, which is exactly what Palmieri et al. (Fluid Resuscitation of Severely Burned Children, ePlasty, PMC11166384, read in full) predict of any single-figure formula when they write that it may 'underestimate needs in small children and overhydrate large children' — a sentence this page previously cited AGAINST its own design and which in fact describes the reason for it. WHAT IS STILL GENUINELY OPEN IS PRACTICE VARIATION, NOT THE COEFFICIENT. See controversy 9 below and the centre-variation caution: starting coefficients across five paediatric burn centres run 2 to 4 with no modal value, delivered volumes cluster near 6.35 mL/kg/%TBSA, and three of the five centres' own guideline estimates came out significantly BELOW what those centres actually delivered (4.53 against 6.35, p<0.001; 4.90 against 6.35, p=0.002; 3.38 against 6.35, p<0.0001). That is a gap between protocol and bedside, closed by titration; it is not evidence that a starting coefficient is set too low. THE MAINTENANCE WEIGHT THRESHOLD IS NOT ONE NUMBER. This score adds maintenance at every weight it accepts, with no threshold at all. The 30 kg figure in wide circulation is real and traceable — it is the ABA position as tabulated in Pisano's 2021 comparison of five ABA-verified paediatric burn centres, and it is the weight BELOW which maintenance is ADDED, not one above which it is withdrawn — but the same table shows the five centres using <20 kg, <20 kg, <30 kg, <40 kg and age under 1 year, and one supplying no additional maintenance IV fluid at all. The German national paediatric guideline (AWMF S2k 006/128, 2024) carries no weight threshold anywhere and applies Holliday-Segar maintenance to all children, which is the structure used here; the German Burn Registry applied Parkland-plus-maintenance to every child under 16 with a burn of 15% TBSA or more on the same basis. No derivation exists for 20, 30 or 40 kg, and that is [SETTLED-ABSENT]: these are pragmatic brackets, not the output of any derivation study, and looking for one again will not find one. Follow local protocol where it differs. AND AT THE OTHER END OF THE WEIGHT RANGE THE MAINTENANCE TERM HAS A SCOPE LIMIT THIS PAGE DOES NOT ENFORCE — STATED HERE BECAUSE THE OTHER PAGE ENFORCES IT. The maintenance figure emitted here is the same Holliday-Segar 100/50/20 mL/kg/day arithmetic as the standalone maintenance-fluids score on this site (holliday-segar), and THAT score refuses to compute below 4 kg. Its reason applies unchanged to the identical arithmetic here: 100 mL/kg/day over-estimates a term neonate substantially — NICE's day-of-life ladder starts at 50-60 mL/kg/day on day 1 and only reaches 120-150 towards the end of the first month, and a 3.2 kg term neonate on day 2 needs roughly 70-80 mL/kg/day where a well 3.2 kg two-month-old needs 100, the same entry giving two answers about a quarter apart — while every guideline scope that excludes neonates is written in AGE (term, 28 days, over 28 days, one month) and neither calculator collects postnatal age, so a weight input cannot implement the rule at all. THIS SCORE STILL ACCEPTS FROM 0.5 kg, AND THAT IS THE DELIBERATE PART. Burn resuscitation genuinely applies to infants — one of Pisano's five centres bands its maintenance rule by age under 1 year precisely because those patients exist — and refusing a burned 3 kg neonate outright would withhold the resuscitation volume as well as the maintenance one, which is the worse failure by some distance. So the divergence between the two pages is a decision rather than a disagreement, and it is written on both of them rather than left for a reader to discover by entering 1 kg twice. WHAT IT MEANS AT THE BEDSIDE, COMPONENT BY COMPONENT. Below roughly 4 kg the two resuscitation outputs are unaffected: the 3 mL/kg/%TBSA coefficient carries no age assumption, and its first-8-hour half is the same arithmetic. The MAINTENANCE output, and therefore the COMBINED TOTAL that contains it, are outside the range their own calculator will compute and should be replaced by the unit's neonatal maintenance regimen, or by the NICE day-of-life ladder, before anything is prescribed. The direction of the error is over-estimation of maintenance in the first days of life, so it compounds the fluid-creep hazard named elsewhere on this page rather than offsetting it, and it does so in the patient least able to absorb it. The 4 kg figure itself is the other score's own implementation proxy, chosen there and labelled there as that project's number: no guideline anywhere states a weight below which Holliday-Segar must not be used, so a unit that draws the line at 3.5 or 5 contradicts nothing published. Collecting postnatal age is what would replace the proxy, on both pages at once. TITRATE TO URINE OUTPUT, AND THE TARGETS GENUINELY DISAGREE. Children are commonly given 1.0-1.5 mL/kg/h (StatPearls), with a widely cited split of 1 mL/kg/h below 30 kg and 0.5 mL/kg/h at or above it (Romanowski & Palmieri 2017), and infants sometimes ~1-2 mL/kg/h; adults ~0.5 mL/kg/h (2024 ABA CPG), against which ABRUPT actually achieved 0.87 (SD 0.51). Three distinct disagreements sit inside that: (a) the target ABOVE 30 kg spans 0.3-1.0 mL/kg/h once the Children's Hospital of Michigan protocol reported by Stevens 2023 is included, which sets 0.8-1.2 mL/kg/h at 30 kg or under and 0.3-0.7 mL/kg/h above it — lower than every other source and lower than the adult band, so displaying a single 0.5 for a 35 kg child picks one end of a threefold range; (b) the BANDING VARIABLE itself differs — AWMF 006/128 bands by developmental stage (infants and toddlers 1-2 mL/kg/h, school age 0.5-1) while North American sources band by weight, and those are not interchangeable, because a large 5-year-old and a small 9-year-old fall on opposite sides; (c) the weight at which the band switches ranges 20-40 kg across the same five centres. The optimal paediatric hourly goal is [SETTLED-ABSENT] — the published targets are expert and review consensus only, Romanowski & Palmieri and AWMF 006/128 both state the optimum as undefined, and AWMF grades all its fluid statements expert consensus, evidence level IV. There is no study to find that settles it. Read urine output alongside blood pressure, lactate and clinical state: oliguria in intra-abdominal hypertension is renal hypoperfusion, not hypovolaemia, and more fluid is the wrong answer to it. EVIDENCE WINDOW, STATED PLAINLY. Restricting the evidence to 2016-2026 finds NO primary derivation for any coefficient in this score. Parkland (1968), Brooke (1953), Galveston (1980), Cincinnati and Holliday-Segar (1957) all predate that window by decades, and everything published inside it is restatement, practice audit or consensus synthesis. The numbers are conventions with 40-70 year provenance, in use and unre-derived. NINE LIVE CONTROVERSIES, PRESENTED AS CONTROVERSIES AND NOT AS SETTLED. (1) The adult starting coefficient — the 2024 ABA CPG recommends 2 mL/kg/%TBSA on exactly two studies totalling 88 patients, neither showing an outcome difference, while ABRUPT 2023 reports a delivered 4.6 mL/kg/%TBSA (SD 2.2) in 379 patients across 21 centres and states that 4 is accurate for burns over 20% TBSA and that a 2 mL/kg/%TBSA goal may not be feasible; same organisation, one year apart, shared authors, and the CPG could not resolve it because ABRUPT had no 2-versus-4 comparator arm. (2) The 'modified Brooke' coefficient is given as 2, as 2-3, and as 3 by three peer-reviewed in-window sources for the same label — which is why all four Parkland and Brooke outputs here print their coefficient rather than relying on a formula name. The maintenance and combined-total outputs name no coefficient because neither is a coefficient formula. (3) The paediatric maintenance threshold: below 30 kg per the ABA, 20-40 kg in practice, or none at all per AWMF. (4) The urine-output banding variable: weight, or developmental stage. (5) The target above 30 kg: 0.3-0.7, or 0.5-1.0. (6) The direction of paediatric error: over-resuscitation in North America, under-resuscitation in the DACH registry. (7) Surface-area versus weight basis: Galveston underpredicts what is actually delivered (Stevens 2023), yet BSA-based formulas are argued to suit patients of 20 kg or less. (8) The inhalation-injury coefficient: two centres escalate to 6 mL/kg/%TBSA against the ABA's 3-4, and one of them withdrew its 6 in 2019 — this score offers no inhalation modifier, because any that is offered needs a date and a source attached. (9) THE PAEDIATRIC STARTING COEFFICIENT ITSELF — still the controversy closest to the number on the screen, but REWRITTEN, because the version of it this page carried at 1.4.0 and 1.5.0 was wrong. It pitted 3 mL/kg/%TBSA against approximately 6 mL/kg/%TBSA as two rival figures for the same quantity; they are not, the 6 being a total that includes maintenance (see the retraction above), and that entry is withdrawn rather than kept for the count. What genuinely varies is where centres START: across the five ABA-verified paediatric burn centres the starting coefficient is 2, 3 or 4 with no modal value, so no single figure can be presented as the field's choice, and three of the five centres' own guideline estimates came out significantly below what those same centres delivered (4.53 vs 6.35 mL/kg/%TBSA, p<0.001; 4.90 vs 6.35, p=0.002; 3.38 vs 6.35, p<0.0001). Protocol against practice, not coefficient against coefficient — which is why the range is displayed and no starting figure is endorsed. HOW WIDE THE SPREAD REALLY IS. Pisano's worked example is the honest limitation line: a 5-year-old weighing 25 kg with a 20% TBSA burn has an estimated 24-hour requirement of 1500 mL to 3560 mL — 3.0 to 7.1 mL/kg/%TBSA — depending only on which of five centres they reach. This score returns 1500 mL for that child, the bottom of that span, and 3100 mL with maintenance included. Delivered volumes ran higher still: 6.35 mL/kg/%TBSA overall across those five centres, from 5.10 to 9.09 by centre, and 6.6-7.6 in Stevens' single-centre cohort, against 4.6 in adults. FLUID CREEP (over-resuscitation) is a documented harm; the 2024 ABA CPG lowered the ADULT starting coefficient to 2 mL/kg/%TBSA to counter it, but that CPG is adults-only and does NOT license a 2 mL pediatric starting rate — there is no graded paediatric CPG for the starting coefficient, because there is no paediatric equivalent of the ABA CPG at all. That is [SETTLED-ABSENT], not unfound: the 2024 CPG (Cartotto 2024) scopes itself explicitly to adults with burns of 20% TBSA or more and frames every PICO question that way, and a 2016-2026 search located no paediatric counterpart. The paediatric starting coefficient therefore rests on convention, and will until somebody writes one. BUT OVER-RESUSCITATION IS NOT THE ONLY FAILURE DIRECTION. In the German Burn Registry — 407 children across 30 centres in Germany, Switzerland and Austria — 86.5% received LESS than Parkland plus Holliday-Segar maintenance, and six of the seven children who died were under-resuscitated relative to it. Its length-of-stay effect estimates are weak (the excess-volume arm's confidence interval crosses 1; only the restriction arm reaches significance, only in the unimputed model, at an 11% reduction) and its authors say the over-resuscitation effect is probably overestimated and can only be estimated imprecisely, so no warning threshold should be built on either result. The cohort is also scald-predominant toddlers with a median age of 1, and its comparator includes maintenance, so 'below Parkland-plus-maintenance' is an easier bar to fall under than 'above Parkland'. NO GUIDELINE ENDORSES A VOLUME CEILING: the 2024 ABA CPG recommends selective intra-abdominal and intra-ocular pressure monitoring instead, a monitoring trigger rather than a cap, and the Ivy index (250 mL/kg/24 h) and the 6 mL/kg/%TBSA trigger both originate outside the evidence window and are endorsed as thresholds by no current guideline. The one hard in-window paediatric bound is AWMF 006/128's Empfehlung 10 (12/12 consensus): in children with 10% TBSA or more, use isotonic crystalloid and do not initially exceed 10 mL/kg body weight per hour. Some references retain 4 mL/kg/%TBSA for children (relying on maintenance to cover baseline needs); centers differ, so the coefficient is institution-specific. EIGHT THINGS ARE [SETTLED-ABSENT], WHICH IS A STRONGER STATEMENT THAN 'NOT FOUND'. Each was searched and established not to exist, so they are recorded as closed rather than pending, and re-searching them is wasted work. The list was five; a second confirmation pass restricted to 2016-2026 reconfirmed all five and added three more: (1) any HUMAN or PAEDIATRIC re-derivation of the 8-h/16-h split, and any guideline-level statement of it — this one is NARROWED, not the whole topic it used to be: the split's derivation as such is now SOURCED to Baxter & Shires 1968, read directly, where it is derived experimentally in dogs, so only the human, paediatric and guideline evidence is absent; (2) the derivation of any maintenance weight threshold at 20, 30 or 40 kg — pragmatic brackets, never tested; (3) the optimal hourly urine-output goal in children — expert and review consensus only; (4) any paediatric equivalent of the ABA CPG — the 2024 CPG scopes itself to adults with 20% TBSA or more, and no paediatric counterpart exists; (5) any head-to-head patient-OUTCOME comparison of Cincinnati, Galveston and Parkland in children — Stevens 2023 compares predictions against volume delivered, not against outcome, and no trial exists; (6) any study testing the 8h:16h FRACTION itself against outcomes — a narrower question than where the split came from, and a different one: whether giving half rather than two-thirds in the first eight hours changes what happens to the patient has never been randomised, compared or adjusted on, so the ratio in universal use has never been tested as a variable; (7) any published observed 0-8h versus 8-24h delivery proportion — and this is the one worth pausing on, because the data exist. ABRUPT collected hourly volumes on 379 adults across 21 centres for 48 hours and the German Burn Registry holds multicentre paediatric fluid data, yet no source reports what share of the 24-hour volume actually went in during the first eight. The nearest measurement is Cartotto 2002, which is adult, n=31 and pre-window, and reports the rate CHANGE at the eight-hour mark rather than the two phases' shares; (8) any paediatric-derived upper volume bound — no ceiling on total resuscitation volume has been derived in children, the Ivy index and the 6 mL/kg/%TBSA trigger being pre-window adult constructs used as outcome markers rather than endorsed thresholds, and AWMF's 10 mL/kg/h being expert consensus at evidence level IV and an early-phase RATE bound rather than a 24-hour volume ceiling. These are absences in the literature, not gaps in this review; each one is a place where the numbers this calculator prints are convention rather than evidence, and that is the honest reading of them. Every computed volume is a starting estimate to be titrated, never a fixed prescription. Weight bounds (0.5-150 kg) are input-validity limits, not cited clinical thresholds — and the 0.5 kg floor is retained deliberately rather than raised to the standalone maintenance score's 4 kg, for the reason set out above: this page discloses the maintenance term's scope limit instead of refusing the burned infant it exists to serve.