Pediatrics · Pediatric Critical Care, Fluids, Electrolytes and Dehydration Management

A 2-year-old child weighing 12 kg is assessed to have 10% dehydration. What is the total fluid required in the first 24 hours using the standard calculation (deficit replacement + daily maintenance by Holliday-Segar), assuming no ongoing losses?

  • A 2200 mL
  • B 2300 mL
  • C 2500 mL
  • D 1900 mL
Correct answer: B. 2300 mL

Explanation

Deficit = 10% × 12 kg × 1000 mL/L = 1200 mL. Holliday-Segar maintenance: 100 mL/kg for first 10 kg = 1000 mL; 50 mL/kg for next 2 kg = 100 mL; total maintenance = 1100 mL/day. Total 24-hour fluid = 1200 + 1100 = 2300 mL. This matches option B. Typically half the deficit is given in the first 8 hours and the remainder over the next 16 hours, added to the maintenance rate.

Reference: Ghai Essential Pediatrics, 10th ed.

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