The Holliday-Segar equation remains the standard method for calculating maintenance fluid requirements. Accounting for deficits when determining the fluid. Maintenance fluid therapy as defined by Holliday and The formula assumes normal renal function . Holliday/Segar formula of ml/kg body weight (BW). The Maintenance Fluid Calculation for Children helps to determine the daily volume of fluids needed based on the weight of a child. This calculation also.

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The second case involved a patient who had surgery to repair a coarctation of the aorta. Maintenance electrolyte requirements must be taken into account, with particular attention paid to sodium requirements, as recent evidence suggests that sodium needs in hospitalized children are higher than originally thought. Phase III is given over 16 hours. Resource Resources and References.

Jospe N, Forbes G. Additional factors must be taken into consideration hollidzy determining insensible fluid losses. Holliday segar method is a widely acceptable method of hopliday maintenance fluid, especially in children.

When monitoring patients who are being treated with maintenance and deficit fluids for dehydration, the most important monitoring parameters are those which defined the dehydration in the first place, such as skin turgor, urine output, and thirst see Table 4 for a complete list.

What will be the maintenance fluid requirement for a child weighing 6kg? Generally these equations involve more calculations, and the basal calorie requirement method requires an indirect calorimeter, which is an expensive piece of equipment. There are three classifications of fluid therapy, maintenance, deficit, and replacement, each of which will be discussed separately. Determining an initial fluid rate for children based upon their needs is essential. Once the degree of dehydration is established, the type of dehydration, defined by serum sodium concentrations, needs to be determined.


A child weighing 14kg was rushed to the emergency department. Patients with mild to moderate dehydration may be rehydrated with oral therapy, even if diarrhea and vomiting continues. Even though it is correct to think about fluid requirements on a hour basis, the delivery pumps used in hospitals are designed to be programmed for an hourly infusion rate. An anuric patient will recycle sodium and potassium, making supplementation generally unnecessary.

Organizing fluid needs into maintenance, deficit, and replacement therapy can provide a systematic, understandable approach to determining fluid therapy.

Body water compartments in children: The interval between doses is longer in premature infants, up to 48 hours, but this is associated with the immaturity of the neonatal kidney, and not total body water. Hypotonic versus isotonic saline in hospitalized children: The approach to patients with hypertonic dehydration is quite different, due to the hyperos-molar state of their circulating blood.

The opposite problem may happen after a patient has been given multiple fluid boluses.

Pediatric Fluid and Electrolyte Therapy

In emergencies, agents which cause a rapid influx of potassium intracellularly are useful as they provide an acute decrease in serum levels. Fluid therapy is divided into maintenance, deficit, hollday replacement requirements. Urine specific gravity can also be used to assess hydration status. Pharmacists are in a unique position to make a positive impact by applying physiological fluid differences and basic pharmacokinetics to pediatric pharmacotherapy.


Pediatr Clin North Am. Open in a separate window. Formulz is generally given over a few hours, with serum sodium checks done throughout in order to avoid hypernatremia. Thus, while the Holliday-Segar method actually estimates kilocalories lost, it is estimated that a loss of 1 kilocalorie requires 1 mL in replacement, so the kilocalorie estimate is forkula efficient target for fluid requirements.

Calculate the maintenance fluid to be given to a patient weighing 22kg. However, once therapy is begun, appropriate monitoring is necessary due to the frequently changing needs of a hospitalized patient.

Fluid therapy; Relation to tissue composition and the expenditure of water and electrolyte. If the blood came from a heel stick, as is frequently done in infants, cell lysis due to the trauma of the needle can cause intracellular potassium to enter the serum locally, leading to falsely elevated formual potassium. The degree of dehydration calculated should always be compared to the clinical signs, gormula may be better indicators of hydration status and are also especially useful when a pre-illness weight is unknown.

The Holliday-Segar Method for calculating Maintenance Fluids and Electrolytes

ohlliday Accounting for deficits when determining the fluid infusion rate is an important factor in treating dehydrated patients; deficit fluid is generally administered over the first 24 hours of hospitalization. However, there has been recent attention in the literature to the potential for causing hyponatremia when using 0. Hospitalized children frequently have elevated fluid requirements due to their illness.