1. What is the Holliday-Segar Formula?

The Holliday-Segar formula is the standard method for calculating maintenance fluid requirements in pediatric patients. It provides an estimate of daily fluid needs based on body weight, accounting for metabolic requirements and insensible losses.

2. How Does the Calculator Work?

The calculator uses the Holliday-Segar formula:

Where:

• First 10 kg: 100 mL per kg
• Next 10 kg (11-20 kg): 50 mL per kg
• Each kg over 20 kg: 20 mL per kg

Explanation: The formula recognizes that metabolic rate and fluid requirements per kilogram decrease as body weight increases.

3. Importance of Pediatric Fluid Calculation

Details: Accurate fluid calculation is crucial in pediatric patients to prevent both dehydration and fluid overload. Children have higher metabolic rates and greater body surface area to weight ratios, making precise fluid management essential.

4. Using the Calculator

Tips: Enter the patient's weight in kilograms. The calculator will provide both daily fluid requirements and hourly IV infusion rates for maintenance fluids.

5. Frequently Asked Questions (FAQ)

Q1: When should maintenance fluids be adjusted?
A: Adjust for fever (add 12% per °C above 38°C), dehydration, renal failure, heart failure, or syndrome of inappropriate antidiuretic hormone secretion (SIADH).

Q2: What fluid type is typically used?
A: For maintenance, use hypotonic solutions like 0.45% normal saline with dextrose, unless contraindicated.

Q3: Are there exceptions to this formula?
A: Yes, neonates and infants under 3 months may require different calculations. Also adjust for clinical conditions affecting fluid balance.

Q4: How accurate is the Holliday-Segar method?
A: It provides a good estimate for maintenance fluids in most pediatric patients but should be individualized based on clinical status.

Q5: What about electrolyte requirements?
A: Maintenance fluids also include electrolytes: sodium 2-4 mEq/kg/day and potassium 1-2 mEq/kg/day, typically provided in balanced solutions.