Calculators
Maintenance Fluids (4-2-1)
Holliday-Segar hourly maintenance fluid rate.
4 mL/kg/h (first 10 kg) + 2 mL/kg/h (next 10 kg) + 1 mL/kg/h (>20 kg)
Hourly rate
65mL/h
NPO deficit (4 h)
260mL
Classic teaching: replace ½ in first hour, ¼ in second, ¼ in third.
References & Further Reading
- 1Journal
Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics. 1957;19(5):823-832.
Citations are provided to direct further study. Always check the most current edition of guidelines and society recommendations — the information in this chapter is a teaching summary, not primary source material.