What is the Holliday-Segar method?

• A. It estimates fluid needs using fixed weight categories and 100 mL of water per 100 kcal metabolized, with adjustments for fever or tachypnea.
• B. It estimates daily protein requirements based on weight.
• C. It estimates electrolyte losses in dehydration by serum sodium.
• D. It estimates caloric needs without regard to fluid.

Answer: (A)

Holliday-Segar is a practical way to estimate maintenance fluid needs in patients, especially children, based on body weight. The method uses fixed weight-based categories to determine how much fluid is needed in a 24-hour period, which is commonly taught in practice as a 4-2-1 rule that translates into hourly maintenance rates. As body weight increases, the amount of fluid per kilogram decreases in a predictable way, ensuring a baseline level of hydration without overloading or underserving the patient.

In addition, adjustments are made for conditions that raise fluid losses, such as fever or rapid breathing, because these situations increase insensible fluid losses and thus require higher maintenance to maintain balance. The statement reflects this approach by emphasizing fixed weight categories and the need to adjust for fever or tachypnea.

The other options describe different concepts—protein needs by weight, electrolyte losses by serum sodium, or caloric needs without regard to fluid—and do not represent how maintenance fluids are typically estimated.