Holliday and Segar developed a method for predicting the maintenance requirements of fluids and electrolytes for the "average" hospitalized patient. This can help guide the orders for fluid and electrolyte administration. The authors are from Indiana University Medical Center in Indianapolis.

Patient restrictions:

(1) The method cannot be used for patients < 2 weeks of age.

(2) I am not sure if there is an upper limit for age. It was developed for children and adolescents.

(3) Figure 1 has body weights extending to 70 kilograms. In obese persons it may not be accurate if the actual body weight is used. I am not sure if the ideal body weight would be adequate. The actual body weight probably should not be used for a person who is severely malnourished.

(4) The method assumes that there are no conditions present significantly affecting fluid and electrolyte loss. If a person has conditions affecting fluid and electrolyte loss (anuria, fever, hyperventilation, etc.), then a more specific technique for replacement should be used.


Body Weight in Kilograms

Caloric Requirements in Kcal per Day

1 to 10

100 * (body weight in kilograms)

11 to 20

(100 * (10 kilograms)) + (50 * ((body weight in kilograms) – 10))

> 20

(100 * (10 kilograms)) + (50 * (10 kilograms)) + (20 * ((body weight in kilograms) – 20))


water requirements in mL =

= (daily caloric requirements in Kcal)



• It is assumed that 100 mL of water is required for each 100 Kcal, through insensible loss and renal excretion.

• Holliday and Segar use "calories", which should be "Calories" (= kcal, or 1,000 calories). This is required to get the values shown in Figure 1, page 824).



Requirement per 100 kcal per day


2 mmol


2 mmol


3 mmol

after the table in Welch

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