1. What is the Holliday-Segar Method?

The Holliday-Segar method is a widely used formula for calculating maintenance intravenous fluid requirements in pediatric patients. It provides a standardized approach based on body weight to ensure appropriate hydration while avoiding fluid overload.

2. How Does the Calculator Work?

The calculator uses the Holliday-Segar formula:

Where:

• \( wt \) — Body weight in kilograms (kg)
• 4 mL/kg/h — For patients weighing 0-10 kg
• 2 mL/kg/h — For the portion of weight between 10-20 kg
• 1 mL/kg/h — For the portion of weight above 20 kg

Explanation: The method recognizes that fluid requirements per kilogram decrease as body weight increases, reflecting the changing body composition and metabolic needs with growth.

3. Importance of Pediatric Fluid Calculation

Details: Accurate fluid calculation is critical in pediatric patients due to their higher body water percentage, increased metabolic rate, and greater susceptibility to both dehydration and fluid overload. Proper maintenance fluids support vital organ function and prevent electrolyte imbalances.

4. Using the Calculator

Tips: Enter the patient's weight in kilograms. Ensure accurate weight measurement as even small errors can significantly affect the calculated fluid requirement in pediatric patients.

5. Frequently Asked Questions (FAQ)

Q1: When should maintenance fluids be adjusted?
A: Adjustments may be needed for fever, increased insensible losses, renal impairment, cardiac conditions, or specific clinical situations like SIADH or diabetes insipidus.

Q2: What fluid type is typically used?
A: Isotonic solutions like 0.9% saline or balanced crystalloids are commonly used, with dextrose added for pediatric patients to prevent hypoglycemia.

Q3: How often should fluid rates be reassessed?
A: Fluid rates should be reassessed at least every 24 hours and whenever there are significant changes in clinical status, weight, or vital signs.

Q4: Are there limitations to the Holliday-Segar method?
A: This method provides maintenance requirements only and does not account for ongoing losses, dehydration, or special clinical conditions that may require additional fluid replacement.

Q5: What about electrolyte replacement?
A: Maintenance fluids should include appropriate electrolytes (sodium, potassium) based on daily requirements and ongoing losses, typically added to the IV solution.