Clinical Tools & Calculators

Pediatric Maintenance Fluids – Holliday–Segar (4-2-1)‎

For educational use. This tool is intended for reference and education. All care decisions require a direct clinical assessment of the patient and independent verification of doses and values by the treating team. The calculation runs locally in your browser, no patient data is sent to any server.

Pediatric Maintenance Fluids – Holliday–Segar (4-2-1)‎

The hourly maintenance fluid rate based on weight, 4 mL/kg/hr for the first 10 kg, then 2 mL/kg/hr for the next 10 kg, then 1 mL/kg/hr for each kg above 20 kg.

50
mL/hour
≈ 1200 mL/day
Source: Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics 1957;19(5):823–832. PMID 13431307
Note: In patients at risk of SIADH (post-neurosurgery, meningitis, pulmonary disease), full maintenance can cause hyponatraemia. Consider running at ½–⅔ maintenance with sodium monitoring.

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