Background: The fluid resuscitation in acute burn injuries are improving. Since 2007, the hourly-adjusted fluid supplement protocol was used in our burn center. More recently, four severe burn patients who underwent such resuscitation also had monitoring for fluid status using the transpulmonary thermodilution technique (PiCCO plus). Aim and Objectives: To share and discuss our experiences by PiCCO monitoring of severe burn patients. Materials and Methods: Since 2007-2009, four patients were resuscitated according to hourly-adjusted fluid resuscitation protocol with monitoring by PiCCO. The parameters were collected and discussed. Results: All patients revealed free of renal failure or pulmonary edema within first 48 hours. The fluid amount of resuscitation was greater than that calculated by Parkland's formula. Conclusion: The PiCCO helped to clarify the details of fluid status, cardiac contractility, pulmonary capillary permeability and the best time of albumin administration.