Formula to help approximate water and caloric loss using a patient's body weight
The Holliday-Segar formula is a formula to help approximate water and caloric loss (and therefore the water requirements) using a patient's body weight.[ 1] [ 2] American Academy of Pediatrics , American Society of Parenteral and Enteral Nutrition , and National Health Service .[ 3] [ 4] [ 5] Malcolm A. Holliday and William E. Segar while at the Indiana University School of Medicine , the researchers concluded a non-linear relationship between energy expenditure and weight alone to determine fluid requirements.
The Holliday-Segar Formula
For each kilogram in this range
Daily caloric cost per kilogram
1–10 kg
100 kcal/kg/day
11–20 kg
50 kcal/kg/day
>20 kg
20 kcal/kg/day
Worked example
To estimate the daily fluid requirements of a 9-year-old boy who weights 32 kg, 10*100 + 10*50 + 12*20 = 1740 kcal per day. At a 1 kcal / 1 mL conversion, the daily H2 0 requirements would therefore be 1740 mL.
Limitations
While generalizable to most cohorts, the Holliday-Segar formula may inadequately estimate caloric requirements in patients affected by fever , hypothermia , or increased activity states (i.e., hyperthyroidism or status epilepticus ).[ 2]
References
^ Holliday, M. A.; Segar, W. E. (1957). "The maintenance need for water in parenteral fluid therapy" . Pediatrics . 19 (5): 823– 832. doi :10.1542/peds.19.5.823 . ISSN 0031-4005 . PMID 13431307 . ^ a b "Dehydration in Children - Pediatrics" . Merck Manuals Professional Edition . Retrieved 2021-01-12 .^ Feld, Leonard G.; Neuspiel, Daniel R.; Foster, Byron A.; Leu, Michael G.; Garber, Matthew D.; Austin, Kelly; Basu, Rajit K.; Conway, Edward E.; Fehr, James J.; Hawkins, Clare; Kaplan, Ron L. (2018). "Clinical Practice Guideline: Maintenance Intravenous Fluids in Children" . Pediatrics . 142 (6): e20183083. doi :10.1542/peds.2018-3083 ISSN 0031-4005 . PMID 30478247 . S2CID 53743151 . ^ Mehta, Nilesh M.; Skillman, Heather E.; Irving, Sharon Y.; Coss-Bu, Jorge A.; Vermilyea, Sarah; Farrington, Elizabeth Anne; McKeever, Liam; Hall, Amber M.; Goday, Praveen S.; Braunschweig, Carol (2017). "Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition" . Journal of Parenteral and Enteral Nutrition . 41 (5): 706– 742. doi :10.1177/0148607117711387 ISSN 0148-6071 . PMID 28686844 . ^ Moritz, Michael L.; Ayus, Juan C. (2015-09-30). "Maintenance Intravenous Fluids in Acutely Ill Patients" . New England Journal of Medicine . 373 (14): 1350– 1360. doi :10.1056/nejmra1412877 . PMID 26422725 . Retrieved 2021-01-12 .
