Maintenance Fluid Dosing for Pediatric Patients

Calculating Maintenance Rate

The American Academy of Pediatrics supports the traditional 4:2:1 formula (Holliday-Segar) for maintenance fluid calculation, which provides 4 mL/kg/hr for the first 10 kg, 2 mL/kg/hr for the second 10 kg, and 1 mL/kg/hr for the remaining weight, resulting in a total of approximately 1600-1800 mL per 24 hours or 65-75 mL/hr for a 36kg child 1
For a 36kg child, the calculated maintenance rate is 76 mL/hr or approximately 1824 mL per 24 hours, using the 4:2:1 formula 1