/Maintenance Fluids

Maintenance Fluids

Daily fluid requirement (Holliday-Segar)

Weight
kg

Total Score

0

Total daily fluid requirement (mL/day). Note: Modify for fever, sweating, or abnormal losses.

099999+Low

Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.

Yasal Uyarı: Bu platformdaki klinik skorlamalar ve algoritmalar yalnızca sağlık profesyonellerini bilgilendirme amaçlıdır. Herhangi bir kesin tıbbi teşhis, tedavi veya klinik karar yerine geçemez. Nihai karar ve sorumluluk hastayı yatak başında değerlendiren hekime aittir.

Clinical Overview

The Holliday-Segar method (commonly taught as the '4-2-1 rule') calculates the baseline daily fluid and caloric requirements for resting, afebrile hospitalized patients who are unable to tolerate oral intake (NPO). It establishes an hourly intravenous fluid rate based on tiered weight brackets to maintain physiological hydration.

Clinical Pearl

While the 4-2-1 rule is pediatric gospel, rigidly applying it to large adults can result in iatrogenic volume overload. For most stable, euvolemic adult patients, a simplified calculation of 25-30 mL/kg/day is generally much safer and clinically adequate.

Pitfalls & Warnings

  • Provides ONLY the baseline 'maintenance' fluid. It completely ignores pathological ongoing losses such as fever (add ~10% for every 1°C above 37°C), surgical drains, nasogastric output, diarrhea, or large burns.
  • Does not account for resuscitation needs in hypovolemic/septic shock, nor does it address electrolyte deficits.

Academic References

Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics. 1957;19(5):823-832.

Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.