Renal Paediatrics General Medicine A

Maintenance Fluid Calculator (Holliday-Segar)

Calculates the daily maintenance fluid volume (mL/24 h) with the Holliday–Segar method (NICE NG29): 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, 20 mL/kg thereafter. Hourly rate ≈ daily volume ÷ 24.

Score interpretation

Holliday–Segar Maintenance Volume (mL/24 h) ≥ 0

Routine maintenance volume. Not for term neonates under 28 days or preterm infants.

→ Use isotonic fluid; adjust for losses, fluid status and electrolytes, and reassess regularly.

Above 2,000 mL/24 h — Females Rarely Need More ≥ 2000.01

NICE NG29: over 24 hours, females rarely need more than 2,000 mL of maintenance fluid.

→ Check the weight entered and cap at 2,000 mL/24 h for females unless there are ongoing losses.

Above 2,500 mL/24 h — Males Rarely Need More ≥ 2500.01

NICE NG29: over 24 hours, males rarely need more than 2,500 mL of maintenance fluid.

→ Check the weight entered and cap at 2,500 mL/24 h unless there are 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 NG29. Intravenous fluid therapy in children and young people in hospital. 2015 (updated 2020).

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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