A 10-year-old (weight 35 kg) requires maintenance IV fluids after abdominal surgery. Using the Holliday-Segar method, what is the correct maintenance fluid rate per hour?

• A 65 mL/hour
• B 75 mL/hour ✓
• C 87.5 mL/hour
• D 100 mL/hour

Explanation

The Holliday-Segar formula calculates daily maintenance fluid and converts to hourly rate: 100 mL/kg for first 10 kg + 50 mL/kg for next 10 kg + 20 mL/kg for each kg beyond 20 kg. For 35 kg: (100×10) + (50×10) + (20×15) = 1000 + 500 + 300 = 1800 mL/day. Hourly rate = 1800/24 = 75 mL/hour. The '4-2-1 rule' shortcut gives the same answer: 4 mL/kg/hour for first 10 kg + 2 mL/kg/hour for next 10 kg + 1 mL/kg/hour for remaining kg = 40 + 20 + 15 = 75 mL/hour.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.