Method of Holliday and Segar for Determining the Maintenance Fluid and Electrolyte Requirements of a Hospitalized Patient

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.

water requirements in mL =

= (daily caloric requirements in Kcal)

where:

• 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).

after the table in Welch