Pediatric Fluid Requirements Calculator (Holliday-Segar)

Holliday-Segar Formula:

\[ \text{Maintenance (ml/day)} = 4 \times \text{first 10kg} + 2 \times \text{next 10kg} + 1 \times \text{rest} \]

Daily Maintenance Fluid:

Hourly Maintenance Rate:

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1. What is the Holliday-Segar Method?

The Holliday-Segar method is the most commonly used approach for calculating maintenance fluid requirements in pediatric patients. It accounts for the metabolic needs of children based on body weight, recognizing that smaller children have proportionally greater fluid requirements per kilogram than older children and adults.

2. How Does the Calculator Work?

The calculator uses the Holliday-Segar formula:

\[ \text{Maintenance (ml/day)} = 4 \times \text{first 10kg} + 2 \times \text{next 10kg} + 1 \times \text{rest} \]

Where:

First 10 kg: 100 mL/kg/day
Next 10 kg (11-20 kg): 50 mL/kg/day
Above 20 kg: 20 mL/kg/day

Explanation: The method provides a weight-based calculation that decreases the mL/kg rate as weight increases, reflecting the decreasing metabolic rate per kilogram with increasing size.

3. Importance of Pediatric Fluid Calculation

Details: Accurate fluid calculation is crucial in pediatrics as children are more susceptible to both dehydration and fluid overload. Maintenance fluids replace normal losses from urine, stool, respiration, and perspiration.

4. Using the Calculator

Tips: Enter the child's weight in kilograms. The calculator will provide both daily maintenance requirements and hourly infusion rates. Always consider clinical status when administering fluids.

5. Frequently Asked Questions (FAQ)

Q1: When should I use this calculation?
A: For calculating maintenance fluids in stable pediatric patients. Adjustments are needed for fever, dehydration, renal failure, or other special conditions.

Q2: What fluid type should I use?
A: Typically D5 1/4NS with 20 mEq KCl/L is used for maintenance, but this may vary based on clinical situation and laboratory values.

Q3: How does this compare to body surface area calculations?
A: Holliday-Segar is simpler and more commonly used for maintenance fluids. Body surface area may be preferred for some medications or in special situations.

Q4: What about neonates?
A: Neonates (especially premature infants) have different fluid requirements and this calculator is not appropriate for them.

Q5: When should I adjust the calculated rate?
A: Adjust for fever (add 12% per °C above 38°C), increased losses (diarrhea, vomiting), or conditions requiring fluid restriction (CHF, renal failure).