A urine output of greater than 1 ml/kg/hr is a good indication of adequate intravascular volume and frequently used to guide fluid resuscitation following severe burns. Heart rate is not always a good indicator of adequate intravascular fluid volume due to following confounding variables:

• the release of catecholamines following tissue injury (which increases heart rate),

• frequent need for sedation (which decreases heart rate)

• pain (which increases heart rate).

Although the patient’s care plan should include a goal monitoring and reducing the risk of infection, this outcome is not an appropriate way to guide fluid resuscitation. The patient will experience significant edema following burn injuries due to third spacing of fluid out of the intravascular space, which is why fluid resuscitation is vital for these patients. Edema is not a reliable marker of intravascular volume as it represents fluid in the extravascular space. A decrease in pitting edema may indicate that shock is resolving, but urine output is a better indicator of appropriate intravascular volume.