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Pediatrics
Pediatric Fluid Resuscitation (Holliday-Segar)
Pediatrics

Holliday-Segar Method — Pediatric Maintenance Fluids

4-2-1 rule for pediatric maintenance IV fluid calculation

Adult maintenance formulas apply; pediatric formula not validated above 60 kg.
Fluid Results
Hourly Rate (4-2-1 Rule)—
Daily Rate—

Fluid Bolus Options

—
10 mL/kg bolus
—
20 mL/kg bolus

4-2-1 Rule Breakdown

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WeightHourly RateDaily Rate
5 kg20 mL/hr480 mL/day
10 kg40 mL/hr960 mL/day
15 kg50 mL/hr1,200 mL/day
20 kg60 mL/hr1,440 mL/day
30 kg70 mL/hr1,680 mL/day
40 kg80 mL/hr1,920 mL/day

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