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Paediatric maintenance fluid requirement
Holliday-Segar weight-based daily and hourly maintenance fluid volumes.
Paediatric maintenance fluid requirement
Body weight
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When to use
- Prescribing baseline maintenance intravenous or enteral fluids for a child, as a reference against measured ins and outs.
Formula
Daily: 100 mL/kg for the first 10 kg + 50 mL/kg for the next 10 kg + 20 mL/kg for each kg >20. Hourly (4-2-1): 4 mL/kg + 2 mL/kg + 1 mL/kg across the same weight bands.
Pearls and pitfalls
- Maintenance volumes assume normal losses; add deficit and ongoing-loss replacement separately.
- Prefer isotonic maintenance fluids in acutely unwell children to reduce the risk of hyponatraemia.