What is the Holliday-Segar maintenance rate per kilogram for the first 10 kg?

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

Answer: (A)

Holliday-Segar uses a tiered approach to estimate daily maintenance fluid needs based on weight. For the portion of body weight up to 10 kg, the maintenance rate is 100 mL per kilogram per day. This higher per-kilogram requirement reflects higher metabolic and insensible losses in smaller children. After 10 kg, the rate drops to 50 mL/kg/day for the next 10 kg, and remains 20 mL/kg/day for each kilogram above 20 kg. So the first 10 kg drives about 1,000 mL/day, and it’s clear how to build total maintenance by adding the contributions from heavier segments. For example, a child weighing 12 kg would need about 1,100 mL/day (10 kg at 100 + 2 kg at 50).