Under Holliday-Segar, how many mL/kg/day are allotted for each additional kilogram above 50 kg?

• A. 100 mL/kg/day
• B. 50 mL/kg/day
• C. 15 mL/kg/day
• D. 20 mL/kg/day

Answer: (C)

Holliday-Segar maintenance fluid is set by weight bands, with the daily per-kilogram allowance changing as weight increases. Specifically, the rule is: 100 mL/kg/day for the first 10 kg, 50 mL/kg/day for the next 10 kg (11–20 kg), and 20 mL/kg/day for every kilogram over 20 kg. That means for any weight above 20 kg, each additional kilogram adds 20 mL/kg/day to the total daily maintenance. So the amount per kilogram for kilograms above 50 kg is 20 mL/kg/day, not 15. For example, a 60 kg patient would have 60 × 20 = 1,200 mL/day (about 50 mL/hour). The options of 100 and 50 mL/kg/day correspond to the earlier weight bands, and 15 mL/kg/day is not part of Holliday-Segar.