Maintenance Fluid Calculator (Holliday-Segar)
Calculates maintenance fluid requirements using the Holliday-Segar method: 100 mL/kg for first 10 kg, 50 mL/kg for next 10 kg, 20 mL/kg thereafter. Also provides hourly rate (4-2-1 rule).
Score interpretation
Neonatal/infant range — confirm with specialist.
→ Use weight-based formula; consult neonatology/paediatrics for adjustments.
Daily maintenance fluid calculated. Adjust for fever (+12%/°C), burns, or ongoing losses.
→ Use isotonic fluid (0.9% NaCl + 5% glucose) unless otherwise indicated. Review electrolytes daily.
Maintenance fluid calculated. Note: maximum daily rate is typically capped at 2500 mL/day for adults.
→ Adjust for clinical status, renal function, cardiac failure, and ongoing losses.
Interpretation bands for the Maintenance Fluids. Apply clinical judgement and local guidance.
References
- Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics. 1957;19(5):823-832.
- NICE Clinical Guideline CG174. Intravenous fluid therapy in adults in hospital. 2013.
Related
Curated clinical cross-links plus same-class fallbacks.
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Potassium chloride with calcium chloride and sodium chloride · Crystalloid IV fluid
- Potassium chloride with calcium chloride sodium chloride and sodium lactate · Balanced crystalloid IV fluid
- Potassium chloride with glucose · IV fluid (potassium + dextrose)
- Potassium chloride with glucose and sodium chloride · IV fluid (mixed)
- Hyperkalaemia Management · UK Kidney Association Guidelines 2020; NICE CKD Guidelines
- Rhabdomyolysis · Renal Association 2018; UpToDate 2024
- Hypocalcaemia (Adult) · Society for Endocrinology
- SIADH (Endocrine Perspective) · European Hyponatraemia Guidelines 2014
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Acute Kidney Injury (AKI) · KDIGO 2012 / NICE AKI 2019
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.