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Formula to help approximate water and caloric loss using a patient's body weight
The Holliday-Segar formula is a formula to help approximate water and caloric loss (and therefore the water requirements) using a patient's body weight.
[1] Primarily aimed at pediatric patients, the Holliday-Segar formula is the most commonly used estimate of daily caloric requirements.
[2] To date, the formula continues to be recommended in the current clinical practice guidelines of the
American Academy of Pediatrics ,
American Society of Parenteral and Enteral Nutrition , and
National Health Service .
[3]
[4]
[5] Developed in 1957 by Drs.
Malcolm A. Holliday and
William E. Segar while at the
Indiana University School of Medicine , the researchers concluded a non-linear relationship between energy expenditure and weight alone to determine fluid requirements.
The Holliday-Segar Formula
For each kilogram in this range
Daily caloric cost per kilogram
1–10 kg
100 kcal/kg/day
11–20 kg
50 kcal/kg/day
>20 kg
20 kcal/kg/day
Worked example
To estimate the daily fluid requirements of a 9-year-old boy who weights 32 kg, 10*100 + 10*50 + 12*20 = 1740 kcal per day. At a 1 kcal / 1 mL conversion, the daily H2 0 requirements would therefore be 1740 mL.
Limitations
While generalizable to most cohorts, the Holliday-Segar formula may inadequately estimate caloric requirements in patients affected by
fever ,
hypothermia , or increased activity states (i.e.,
hyperthyroidism or
status epilepticus ).
[2] The formula can also only be applied to patients above 2 weeks of age.
References
^ Holliday, M. A.; Segar, W. E. (1957).
"The maintenance need for water in parenteral fluid therapy" . Pediatrics . 19 (5): 823–832.
doi :
10.1542/peds.19.5.823 .
ISSN
0031-4005 .
PMID
13431307 .
^
a
b
"Dehydration in Children - Pediatrics" . Merck Manuals Professional Edition . Retrieved 2021-01-12 .
^ Feld, Leonard G.; Neuspiel, Daniel R.; Foster, Byron A.; Leu, Michael G.; Garber, Matthew D.; Austin, Kelly; Basu, Rajit K.; Conway, Edward E.; Fehr, James J.; Hawkins, Clare; Kaplan, Ron L. (2018).
"Clinical Practice Guideline: Maintenance Intravenous Fluids in Children" . Pediatrics . 142 (6): e20183083.
doi :
10.1542/peds.2018-3083 .
ISSN
0031-4005 .
PMID
30478247 .
S2CID
53743151 .
^ Mehta, Nilesh M.; Skillman, Heather E.; Irving, Sharon Y.; Coss-Bu, Jorge A.; Vermilyea, Sarah; Farrington, Elizabeth Anne; McKeever, Liam; Hall, Amber M.; Goday, Praveen S.; Braunschweig, Carol (2017).
"Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition" . Journal of Parenteral and Enteral Nutrition . 41 (5): 706–742.
doi :
10.1177/0148607117711387 .
ISSN
0148-6071 .
PMID
28686844 .
^ Moritz, Michael L.; Ayus, Juan C. (2015-09-30).
"Maintenance Intravenous Fluids in Acutely Ill Patients" . New England Journal of Medicine . 373 (14): 1350–1360.
doi :
10.1056/nejmra1412877 .
PMID
26422725 . Retrieved 2021-01-12 .