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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In phase I, a bolus of fluid is given in order to restore blood volume to ensure adequate perfusion of critical organs, such as the brain.

Monitoring serum electrolytes is necessary if the patient has electrolyte abnormalities, but when examining hydration, the most important indices to watch are the clinical parameters mentioned earlier. The Holliday-Segard nomogram approximates daily fluid loss, and therefore the daily fluid requirements, as follows:.

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

Each of these examples demonstrates a situation where there is an ongoing loss which would not be met by administering only maintenance fluids. Hydration status can have an important impact on drug therapy, and should be considered when using medications with large volumes of distribution. Maintenance fluids are given to compensate for ongoing losses and are required for all patients.


Each of these methods, while providing a reasonable estimate of maintenance fluids, cannot account for the physiologic changes that occur in hospitalized children. Any renal dysfunction requires frequent electrolyte monitoring. This equation, also listed in Table 2arrives at similar volumes of fluid as the traditional Holliday-Segar equation. Holliday and Segar collated information from a number of studies, including their own, and concluded the following:.


Additional factors must be taken into consideration when determining insensible fluid losses. Please review our privacy policy. The subsequent symptoms of hyponatremia were mistaken for a zegar reaction from promethazine, and the child was treated with diphenhydramine. The Holliday-Segar equation remains the standard method for calculating maintenance fluid requirements.

The Holliday-Segar Method for calculating Maintenance Fluids and Electrolytes

Requirements for children are higher than those for adults for multiple reasons. Treatment of burns in children. On the second post-operative day, the patient was unarousable, and this was confused for a side effect of receiving hydromorphone. Water loss and therefore water requirement is a function of caloric expenditure.

The changes that take place as a child grows have a great effect on fluid requirements, making special attention to fluid therapy essential in pediatric pharmacotherapy. In this situation, the volume of distribution may temporarily be increased, and thus a standard dose may lead to subtherapeutic serum concentrations.

In both of these cases, symptoms of hyponatremia were explained as side effects of drugs.

By paying close attention to the fluid needs of pediatric patients and monitoring response to fluid therapy, the pediatric pharmacist can have a positive influence on the health of the child. Notify me of new comments via email. formhla


While there are many factors that contribute to the fluid and electrolyte needs of children, approaching this therapy in a systematic, organized fashion can help pharmacists meet ongoing as well as changing needs of the patient.

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Fluid and Electrolyte Therapy

It is important to consider maintenance electrolyte requirements when choosing a maintenance fluid for a child. The deficit fluid volume should be added to the maintenance fluid volume needed for hollidzy hours, and the total should be administered over 48 hours.

Some more words of caution: Data from Rusconi F, et al. Monitoring Parameters for Srgar Fluid Therapy. You are commenting using your Twitter account. The most commonly used technique to calculate maintenance fluids for children is the Holliday-Segar method Table 2. Hydration 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.


Physiologic differences also play a role in fluid therapy. The first parameter for monitoring is oral intake Table 6. Total body water content changes drastically from before birth until one year of age.