Paediatrics · ICU and Critical Care
Pediatric Maintenance IV Fluids (4-2-1 Rule) calculator
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Clinical inputs
Allowed range: 6.61–176.37 lb
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Clinical inputs
- Weight (kg)Accepted range: 3 to 80
Primary source
Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics. 1957;19(5):823-832. DOI: 10.1542/peds.19.5.823. PMID: 13431307. Scope: Holliday-Segar daily water need: 100 mL/kg for the first 10 kg, 50 mL/kg for the second 10 kg, 20 mL/kg for each kg above 20 kg per 24 h. The hourly 4-2-1 rule restates this as 4 mL/kg/h for the first 10 kg, 2 mL/kg/h for the next 10 kg and 1 mL/kg/h thereafter (UTMB Core Concepts of Pediatrics). Maintenance water only; deficits and ongoing losses are extra. (1957)
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