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