Skip to main content
Health

Pediatric Maintenance Fluid Calculator (Holliday-Segar)

Enter the body weight: the tool applies the Holliday-Segar (1957) maintenance schedule — first 10 kg × 100 mL/kg/day, next 10 kg × 50 mL/kg/day, and > 20 kg × 20 mL/kg/day — and converts to an mL/hr infusion rate. The bedside "4-2-1 mL/kg/hr" mnemonic value is shown alongside for sanity-checking. Intended for normally-hydrated paediatric inpatients without ongoing losses; dehydration deficit, vomiting / diarrhoea, burns, cardiopulmonary disease and SIADH all need separate adjustment.

Common age / weight presets

Result

Maintenance IV rate

mL/hr

Daily total

mL/day

4-2-1 bedside rate (mL/hr)

Bedside mnemonic: first 10 kg × 4 mL/kg/hr, next 10 kg × 2 mL/kg/hr, remainder × 1 mL/kg/hr. Differs slightly from mL/day ÷ 24 because 100/24 ≈ 4.17.

Per-tier breakdown (mL/day)

  • First 10 kg × 100 mL/kg
  • Next 10 kg × 50 mL/kg
  • > 20 kg × 20 mL/kg

For clinical use, follow institutional guidance. This calculation gives baseline maintenance only — it does not account for dehydration deficit or ongoing losses (vomiting, diarrhoea, drains). SIADH risk, post-operative, cardiac, pulmonary and burn patients usually need adjusted rates — see your local protocol (e.g. NICE NG29 in the UK, AAP 2018 in the US).

Formula

First 10 kg : 100 mL ⁄ kg ⁄ day 10 – 20 kg : 50 mL ⁄ kg ⁄ day (add) > 20 kg : 20 mL ⁄ kg ⁄ day (add) mL ⁄ hr = mL ⁄ day ÷ 24 Bedside 4-2-1: first 10 kg × 4 + next 10 kg × 2 + remainder × 1 (mL ⁄ kg ⁄ hr)

Frequently asked

Does the Holliday-Segar formula apply to adults too?

Partially — with caveats. The original 1957 paper validated the formula in a paediatric range (0 – 30 kg), aligning fluid need to metabolism (≈ 100 mL per 100 kcal). Extending it linearly to adults gives 70 kg → 2,500 mL/day, which sits within the usual 2,000 – 2,500 mL/day adult reference. But beyond ~80 kg the formula tends to over-estimate need — e.g. 100 kg → 3,100 mL/day is generally too much. Adult inpatient fluid orders more often use 30 – 35 mL/kg/day or 1 mL/kcal, and many institutions calculate against ideal body weight rather than actual weight to avoid over-resuscitating obese patients. For adults > 80 kg, switch to an adult-specific formula and follow your local guideline.

Why do current guidelines recommend isotonic (0.9 % NaCl) instead of the older 0.18 % saline + 5 % dextrose mix?

Because three decades of evidence have shown that hypotonic maintenance fluids significantly raise the risk of hospital-acquired hyponatraemia, especially when ADH is elevated — post-operative, lower-respiratory infection, CNS infection. From 2007 onwards a series of RCTs (Choong, Friedman, McNab and others) demonstrated that isotonic fluids (0.9 % NaCl or Plasmalyte with 5 % dextrose) cut the incidence of hyponatraemia by about 50 – 80 % without increasing hypernatraemia. NICE NG29 (2015) and the American Academy of Pediatrics (2018) now both list isotonic as the standard maintenance fluid in children. This calculator computes *volume* only — it does not prescribe a composition; choose the isotonic preparation recommended by your institution when writing the order.

Related tools

BMI (Body Mass Index) Calculator

Enter height and weight to get your BMI and category (underweight / normal / overweight / obese).

BMR & TDEE Calculator

Estimate daily BMR and TDEE using Mifflin-St Jeor or Harris-Benedict, with calorie targets for cutting and bulking.

Body Fat Calculator (US Navy method)

Estimate body fat percentage using the US Navy circumference formula (neck, waist, plus hip for women).

Sleep Cycle Calculator

Suggest ideal bedtimes or wake times based on 90-minute sleep cycles, so you wake up between cycles instead of mid-deep-sleep.

Daily Water Intake Calculator

Estimate daily water intake from body weight, exercise duration and climate so you stay hydrated without overdoing it.

Running Pace Calculator

Compute pace per km / per mile from distance and time, or project finish time from a target pace — covers 5K, 10K, half- and full-marathon distances.

Heart Rate Zone Calculator

Compute 5 training heart rate zones from age and optional resting HR using the Karvonen formula (Z1 warm-up to Z5 max effort).

Lean Body Mass (LBM) Calculator

Estimate lean body mass (LBM), fat mass and body fat % from height, weight and sex using the Boer, Hume and James formulas.

Daily Macros Calculator (carbs / protein / fat)

Split a daily calorie target into grams of carbs, protein and fat at any macro ratio.

One-Rep Max (1RM) Calculator

Estimate one-rep max from a sub-maximal lift (weight × reps) with Epley, Brzycki, Lombardi and Lander formulas, plus a 50–95% intensity training table.

Body Surface Area (BSA) Calculator

Estimate body surface area from height and weight using the Mosteller, Du Bois, Haycock and Boyd formulas — commonly used in drug-dosing, chemotherapy and cardiac-index calculations.

Race Time Predictor (Riegel Formula)

Project a finish time at one distance from a known time at another distance using the classic Riegel formula T₂ = T₁ × (D₂/D₁)^1.06.

Mean Arterial Pressure (MAP) Calculator

Compute mean arterial pressure from systolic and diastolic blood pressure with clinical bands and pulse-pressure context: MAP = DBP + (SBP − DBP)/3.

Pack-Year (Smoking History) Calculator

Compute cumulative smoking exposure in pack-years from cigarettes per day and years smoked, with lung-cancer-screening thresholds.

Waist-to-Hip Ratio (WHR) Calculator

Divide waist by hip circumference and check the WHO risk bands — a quick screen for central obesity and cardiovascular risk.

Exercise Calorie Burn (MET) Calculator

Use METs, body weight and duration to estimate calories burned for common activities (running, hiking, swimming, cycling and more).

Caffeine Half-Life Calculator

Pick the dose (mg) and the time you drank it; the calculator uses the standard ~5-hour caffeine half-life to project how many milligrams remain hour-by-hour, including the level at bedtime.

Body Adiposity Index (BAI) Calculator

Bergman’s BAI estimates body-fat percentage from hip circumference and height alone (BAI = hip ÷ height^1.5 − 18) — no scale required.

TDEE (Total Daily Energy Expenditure) Calculator

Enter age, sex, height and weight to compare all five activity levels side-by-side — instantly see the daily calories you need to maintain weight.

Blood Alcohol Concentration (BAC) Calculator

Estimate blood alcohol concentration (BAC %) with the Widmark formula from drinks consumed, body weight, sex and hours elapsed — and compare against the Hong Kong 0.05% drink-driving limit.

VO₂ Max Calculator (Cooper 12-Minute Run Test)

Enter your distance covered in a 12-minute run to estimate VO₂ max and read off the age/sex fitness category.

Daily Protein Intake Calculator

Enter your bodyweight and training goal to get a science-backed daily protein range (g/day) and per-meal split, based on RDA, ISSN and ACSM/AND/DC guidelines.

Ovulation & Fertility Window Calculator

Enter your last menstrual period (LMP) date and average cycle length to estimate the next ovulation day, fertile window and next period.

Total Body Water (TBW) Calculator

Estimate total body water (in litres) and the percentage of body weight using the Watson formula based on age, sex, height and weight.

Steps to Distance & Calories Calculator

Enter step count, height (auto-derives stride length) and body weight to estimate distance walked (km / mi), stride length, calories burned and your daily activity tier.

Glycemic Load (GL) Calculator

Enter a food's glycemic index (GI) and grams of carbs per serving to compute glycemic load GL = GI × carbs ÷ 100 — a better predictor of real blood-sugar response than GI alone.

HbA1c ↔ Average Blood Glucose (eAG) Converter

Convert HbA1c (%) to estimated average glucose (eAG) in both mg/dL and mmol/L — and back again — to help diabetes and prediabetes patients read their lab reports.

FFMI (Fat-Free Mass Index) Calculator

Enter height, weight and body-fat percentage to compute Fat-Free Mass Index (FFMI) and the height-adjusted FFMI used to gauge muscularity.

Ideal Body Weight Calculator (Devine / Robinson / Miller / Hamwi)

Enter height and sex to compare the four classic ideal-body-weight formulas (Devine, Robinson, Miller, Hamwi), with their average and a ±10 % healthy-weight band.

APGAR Newborn Score Calculator

Select 0–2 points for each of the five APGAR signs (Appearance / Pulse / Grimace / Activity / Respiration) to get the total APGAR score (0–10) and clinical band (normal / moderately depressed / severely depressed).

Glasgow Coma Scale (GCS) Calculator

Pick eye-opening (1–4), verbal (1–5) and motor (1–6) responses to compute the Glasgow Coma Scale total (3–15) with mild / moderate / severe banding.

Pulse Pressure Calculator (PP = SBP − DBP)

Enter systolic (SBP) and diastolic (DBP) blood pressure; the tool returns the pulse pressure and mean arterial pressure (MAP), then classifies the result as low / normal / elevated using the < 40, 40–60 and > 60 mmHg bands — the textbook signal for cardiovascular risk on a routine BP report.

eGFR Calculator (Kidney Function, CKD-EPI 2021)

Enter serum creatinine, age and sex; the tool applies the 2021 NKF / ASN-recommended CKD-EPI formula (race-free) to estimate glomerular filtration rate (eGFR) and classifies the result into CKD stages G1–G5 — the standard reading of a kidney-function lab report.

Creatinine Clearance Calculator (Cockcroft–Gault)

Enter age, weight, serum creatinine and sex; the tool applies the 1976 Cockcroft–Gault formula to estimate creatinine clearance (CrCl, mL/min) — still the FDA- and EMA-required formula for renal dose adjustment in most drug labels.

Waist-to-Height Ratio Calculator (WHtR)

Enter waist circumference and height in any units; the tool returns the waist-to-height ratio (WHtR) and classifies it against the universal "keep your waist to less than half your height" cut-off (< 0.5) — a more sensitive central-obesity signal than BMI.

Friedewald LDL Cholesterol Calculator

Enter total cholesterol, HDL and triglycerides; the Friedewald equation (LDL = TC − HDL − TG / 5 or / 2.2 SI) estimates LDL-C and grades the result by NCEP ATP III risk bands.