The adequacy of fluid resuscitation will be monitored in burn patients using microcirculation.

Microcirculation camera will be placed on the base of the tongue and at different four quadrants. • Microcirculation parameters at baseline and after 8h , 16h and 24h of fluid resuscitation will be recorded. Fluid resuscitation with lactated ringer according to Parkland formula (4 ml/kg/%TBSA) 50% given during the first 8 hours, with the remainder given during the following 16 hours, will be initiated to maintain a urinary output of 0.5ml/kg/hr.Norepinephrine infusion will be started in case of circulatory failure at a rate of 0.02mic/kg/min to maintain MAP of 65-70mmHg.

Inclusion Criteria:

• Age more than 18 years old
• Burn >20% TBSA
• Patients with burn admitted within the 1st 6 hours

Exclusion Criteria:

• Age < 18 years old.
• Pregnant patients.
• Patients with severe renal insufficiency.
• Patients shocked due to other causes as sepsis, hypovolaemia or cardiogenic shock
• Patients with airway edema that preclude the measurement of sublingual microcirculation

Patients with burns greater than 20% TBSA admitted to ICU within the 1st 6 hours post-burn