The maintenance need for water in parenteral fluid therapy

Abstract

It is generally agreed that the maintenance requirements for water of individuals is determined by their caloric expenditure. By means of the following formulae, the caloric expenditure of hospitalized patients can be determined from weight alone. For weights ranging from 0 to 10 kg, the caloric expenditure is 100 cal/kg/day; from 10 to 20 kg the caloric expenditure is 1000 cal plus 50 cal/kg for each kilogram of body weight more than 10; over 20 kg the caloric expenditure is 1500 cal plus 10 cal/kg for each kilogram more than 20.'Maintenance requirements for water depend upon insensible loss of water and renal loss. An allowance of 50 ml/loO cal/day will replace insensible loss of water, and 66.7 ml/lOO cal/day will replace the average renal loss so that the total requirement is 116.7 ml/lOO cal/day. As water of oxidation will supply approximately 16.7 m1/100 cal/day, the remaining 100 m1/100 cal/day must be supplied to meet the remaining water losses of patients on parenteral fluid therapy.'Maintenance requirements of sodium, chloride and potassium are 3.0, 2.0 and 2.0 mEq/100 cal/day, respectively.'A formula devised 35 years ago, which is still used every day. ReferencesHolliday M.A. & %gar W.E. (1957) The maintenance need for water in parenteral fluid therapy. Pediatrics 823-832. 0 Pediatrics Submitted by Nishan G. Goudsouzian MD.

Safety and efficacy of isotonic (0.9%) vs. hypotonic (0.18%) saline as maintenance intravenous fluids in children: A randomized controlled trial

“…Maintenance fluid volume for administration was calculated using Holliday and Segar formula [1]. Both groups also received 1 mL of potassium chloride per 100 mL of intravenous fluids.…”

“…R ecommendation for the use of a hypotonic saline solution (0.18% saline in 5% dextrose) in children is still a debated subject despite half a century of its practice [1]. Reports of symptomatic hyponatremia in hospitalized surgical and non-surgical pediatric patients -caused primarily by various non-osmotic release of vasopressin, but contributed by electrolyte-free water input in a proportion of cases -have fueled these debates [2][3][4][5].…”

Perioperative fluid management and postoperative hyponatremia in children

“…For decades after its publication, the 1957 article coauthored by Malcolm Holliday and William Segar served as the standard fluid management guideline for hospitalized children [1]. These authors proposed that pediatric water maintenance needs parallel energy expenditure: 100 mL/100 kcal for the first 10 kg of body weight, 50 mL/100 kcal for 11-20 kg, and 20 mL/100 kcal for every kilogram of body weight above 20 kg.…”

On water, salt and more …

“…Lange Zeit wurden für Kinder perioperativ hypotone Infusionslösungen eingesetzt. Dies ging auf Arbeiten aus den 50er Jahren zurück, in denen der Flüs-sigkeits-und Elektrolytbedarf aus der Stoffwechselrate von Kindern und der Zusammensetzung von Milch abgeleitet wurde [6]. Diese leicht nachvollziehbaren Überlegungen verbreiteten sich rasch in der Pädiatrie und der Kinderanästhe-sie und wurden in der Folgezeit durch die verschiedenen natriumarmen pädia-trischen Infusionslösungen abgebildet.…”