holliday segar calculator

Pediatric Maintenance Fluid Calculator

Use the Holliday-Segar method to estimate daily and hourly maintenance fluids for children.

Formula is calculated in kilograms automatically.

Quick formula: 100/50/20 mL/kg/day and 4/2/1 mL/kg/hour.

What is the Holliday-Segar formula?

The Holliday-Segar formula is a standard pediatric method for estimating maintenance fluid requirements. It gives clinicians a practical starting point for IV or oral fluid planning in children who are not drinking enough on their own.

It is commonly taught in pediatrics, emergency medicine, anesthesia, and critical care because it is simple, fast, and generally reliable for initial estimates.

Holliday-Segar formula at a glance

Daily maintenance (100/50/20 rule)

Weight Band Daily Fluid Requirement
First 10 kg 100 mL/kg/day
Second 10 kg (10-20 kg) 50 mL/kg/day
Each kg above 20 kg 20 mL/kg/day

Hourly maintenance (4/2/1 rule)

  • First 10 kg: 4 mL/kg/hour
  • Second 10 kg: 2 mL/kg/hour
  • Each kg above 20 kg: 1 mL/kg/hour

Worked examples

Example 1: 8 kg infant

Daily: 8 × 100 = 800 mL/day
Hourly: 8 × 4 = 32 mL/hour

Example 2: 17 kg child

Daily: (10 × 100) + (7 × 50) = 1000 + 350 = 1350 mL/day
Hourly: (10 × 4) + (7 × 2) = 40 + 14 = 54 mL/hour

Example 3: 32 kg child

Daily: 1500 + (12 × 20) = 1500 + 240 = 1740 mL/day
Hourly: 60 + (12 × 1) = 72 mL/hour

When to use caution

The calculator provides an estimate, not a complete clinical order. Real-world fluid decisions may differ based on diagnosis and current physiology.

  • Shock, sepsis, burns, major trauma, or significant dehydration
  • Renal disease, heart failure, liver disease, SIADH, or endocrine disorders
  • Neonates and medically complex infants who need specialist protocols
  • Patients with electrolyte abnormalities or altered urine output

Practical bedside tips

  • Reassess hydration status frequently (vitals, exam, urine output, labs).
  • Choose fluid type based on institutional protocol and patient condition.
  • Adjust for fever, losses (vomiting/diarrhea), drains, and NPO duration.
  • In hospitalized patients, monitor sodium trends to avoid dysnatremia.

Bottom line

The Holliday-Segar method is a strong starting point for pediatric maintenance fluids. Use it for quick, structured estimates, then individualize with clinical judgment and ongoing reassessment.

Educational use only. This page does not replace professional medical advice, diagnosis, or treatment.

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