The Holliday-Segar equation remains the standard method for calculating maintenance fluid requirements. Accounting for deficits when determining the fluid. Maintenance fluid therapy as defined by Holliday and The formula assumes normal renal function . Holliday/Segar formula of ml/kg body weight (BW). The Maintenance Fluid Calculation for Children helps to determine the daily volume of fluids needed based on the weight of a child. This calculation also.

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Holliray status can affect the dose needed to achieve therapeutic concentrations, and dehydrated patients may be at risk for toxicity if standard doses of drugs with high volumes of distribution are used. The degree of dehydration calculated should always be compared to the clinical signs, which may be better indicators of hydration status and are also especially useful when a pre-illness weight is unknown.

The second case involved a patient who had surgery to repair a coarctation of the aorta. The increased volume of distribution necessitates a large dose. Holliday and Segar collated information from a number of studies, including their own, and concluded the following: Calculate the maintenance fluid to be given to a patient weighing 22kg.

Pharmacists should always pay particular attention to the hydration status of patients, as the volume of distribution for water soluble drugs can be drastically affected by a change in volume status. T he commonly used method for approximating water loss and therefore the water requirement is the Holliday-Segar nomogram: This equation, also listed in Table 2arrives at similar volumes of fluid as formulz traditional Holliday-Segar equation.


Holliday-Segar formula | definition of Holliday-Segar formula by Medical dictionary

Fluid and electrolytes clinical aspects. Patients with hypotonic or isotonic dehydration are given fluids using the same technique to calculate fluid amount and rate Table 5.

In both of these cases, symptoms of hyponatremia were explained as side effects of drugs. Hyperkalemia can be treated with a variety of medications.

When determining the amount of fluid seegar be administered in phases II and III, the fluid volume given during phase I should be subtracted from the deficit fluid. Additional factors must be golliday into consideration when determining insensible fluid losses.

You are commenting using your WordPress. While insensible losses from ventilation may not account for a large amount of ongoing normal losses, conditions that increase respiratory rate e.

Maintenance Fluid Requirements

Maintenance Fluids Maintenance fluids are given to compensate for ongoing losses and are required for all patients. Prevention of hospital-acquired hyponatremia: Abstract Managing fluids and electrolytes in children is an important skill for pharmacists, formuls can play an important role in monitoring therapy.

Pediatr Clin North Am. Thanks Nurse Hassan Like Like. Calculate the maintenance water required for 30 kg child?

Administering the deficit fluid faster causes osmotic fluid shifts, which can result in cerebral edema and convulsions. Phase II is given over 8 hours. Requirements for children are higher than those for adults for multiple reasons.

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Fluid and Electrolyte Therapy

An anuric patient will recycle sodium and potassium, making supplementation generally unnecessary. Holliday Segar determined how many calories a patient burns as a factor of weight. Management of severe hyperkalemia.


This formula relates water loss to the caloric expenditure. Hollidday, seizures were misperceived as fidgeting from pain.

Concentrations of electrolytes are determined in large part by renal function, 7 making consideration of the patient’s clinical status vitally important when considering electrolyte requirements in children. By the time a patient is out of the neonatal period, the usual dose of gentamicin is 2. Caloric expenditure, and therefore the water requirement, for the hospitalized patient can be estimated from the nomogram shown below.

The Holliday-Segar Method

When considering fluid requirements in hospitalized children, potential increased or decreased needs should always be kept in mind. N Engl J Med. The deficit fluid volume should be added to the maintenance fluid volume needed for 48 hours, and the total should be administered over 48 hours. Replacement fluids are defined as those given to meet ongoing losses due to medical treatment.

Reference values for respiratory rate in the first 3 years of life. In emergencies, agents which cause a rapid influx of potassium intracellularly are useful as they provide an acute decrease in serum levels. Isotonic fluids are used because they provide rapid volume expansion in the plasma and extracellular fluid.

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