Pediatric IV Maintenance Fluid Calculator
Based on Australian Guidelines (e.g., The Royal Children’s Hospital, Melbourne)
Patient Data
Guidelines Reference
This calculation uses the Holliday-Segar method (4-2-1 rule) which is widely accepted for maintenance fluid requirements in pediatrics:
- **First 10 kg:** 4 mL/kg/hour
- **Next 10 kg:** 2 mL/kg/hour
- **Subsequent kg:** 1 mL/kg/hour
Calculated Fluid Requirements
Total Daily Maintenance Volume
0 mL/day
Calculation breakdown will appear here.
Maintenance Infusion Rate (4-2-1 Rule)
0 mL/hour
Calculation breakdown will appear here.
Clinical Disclaimer
These calculations are for *maintenance* fluid requirements only. They do not account for deficits, ongoing losses, hyperthermia, renal/cardiac impairment, or other complex clinical situations. **Always** refer to local institutional guidelines (such as the full RCH IV Fluid Guidelines) and consult a senior medical officer before initiating IV fluids. This is a reference tool, not a substitute for clinical judgment.
About This Calculator
This RCH Fluid Calculator is designed to help Australian healthcare professionals, students, and parents estimate pediatric maintenance and bolus fluid requirements. It follows the Holliday–Segar method (100/50/20 mL/kg) and includes the standard 20 mL/kg resuscitation bolus as outlined in Royal Children’s Hospital (RCH) clinical guidelines.
It’s intended for educational and reference purposes only—not as a substitute for clinical judgment or local hospital protocols. Always verify results with official RCH guidelines or a supervising clinician before applying in practice.
Patient Weight and Daily Volume
Daily hydration needs are based on weight in kilograms. For infants or children under 10 kg, provide 100 mL per kg per day. For patients between 10 kg and 20 kg, give 1000 mL plus 50 mL for each kg above 10 kg. For children over 20 kg, give 1500 mL plus 20 mL for each kg above 20 kg. This ensures proper daily intake according to weight categories.
Maintenance Rates
Daily volume is usually divided into hourly rates. For children under 10 kg, divide total daily volume by 24 to determine hourly rate. For children 10–20 kg, calculate total intake first, then divide by 24. Patients over 20 kg follow the same procedure. Adjust rates as needed based on clinical condition or ongoing losses.
Electrolyte Composition
Sodium and potassium requirements follow age and weight recommendations. Sodium ranges from 2–4 mEq per kg per day for infants and 1–2 mEq per kg per day for older children. Potassium is added only after confirming urine output, typically 1–2 mEq per kg per day. Chloride is usually matched to sodium.
Special Considerations
For patients with vomiting, diarrhea, or fever, extra intake may be required. Calculate additional losses and add to maintenance volume. Monitor urine output, weight changes, and vital signs to adjust rates. For surgical patients or those with restricted intake tolerance, slower rates or altered compositions may be indicated.
Summary Table
Weight-based daily requirements follow three main brackets: under 10 kg (100 mL/kg/day), 10–20 kg (1000 mL + 50 mL/kg above 10 kg), over 20 kg (1500 mL + 20 mL/kg above 20 kg). Hourly rate is total daily volume divided by 24. Electrolytes are adjusted to age, weight, and urine output. Extra losses are calculated separately and added to total intake.