Pediatric Maintenance Fluids
Calculates daily and hourly maintenance fluids from the child weight.
When to use
Initial estimate of maintenance fluids in children and adolescents, before adjusting for losses and clinical conditions.
Pearls and pitfalls
- The rule uses 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg and 20 mL/kg for each additional kg.
- Maintenance does not replace deficits or ongoing losses; shock and dehydration require separate expansion.
- Adjust in kidney failure, heart failure, the postoperative period and conditions with fluid retention.
- The formula was derived for parenteral therapy and is not an automatic volume prescription.
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Formula
Up to 10 kg: 100 mL/kg/day; 10 to 20 kg: 1000 mL plus 50 mL/kg per kg above 10; above 20 kg: 1500 mL plus 20 mL/kg per kg above 20.
Evidence
Maintenance rule derived from caloric expenditure and the relation between water need and energy in children.
References
- Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics. 1957;19(5):823-832. doi:10.1542/peds.19.5.823
Frequently asked questions
What is Pediatric Maintenance Fluids?
Calculates daily and hourly maintenance fluids from the child weight. Initial estimate of maintenance fluids in children and adolescents, before adjusting for losses and clinical conditions.
How is the result calculated?
Up to 10 kg: 100 mL/kg/day; 10 to 20 kg: 1000 mL plus 50 mL/kg per kg above 10; above 20 kg: 1500 mL plus 20 mL/kg per kg above 20.
How should the result be interpreted?
Maintenance rule derived from caloric expenditure and the relation between water need and energy in children.
What are the sources?
Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics. 1957;19(5):823-832.