What is the recommended fluid requirement for an 11 kg girl over 24 hours?

Fluid Requirement Calculation for an 11 kg Girl

For an 11 kg girl, the recommended 24-hour fluid requirement is 1050 ml, calculated using the Holliday-Segar formula. 1

Calculation Method Using Holliday-Segar Formula

The Holliday-Segar formula remains the standard method for calculating maintenance fluid requirements in children 1, 2. This formula calculates fluid needs based on weight tiers:

1. First 10 kg: 100 ml/kg/day (4 ml/kg/hour)
2. Second 10 kg: 50 ml/kg/day (2 ml/kg/hour)
3. Each additional kg: 25 ml/kg/day (1 ml/kg/hour)

For an 11 kg child:

• First 10 kg: 10 kg × 100 ml/kg/day = 1000 ml/day
• Additional 1 kg: 1 kg × 50 ml/kg/day = 50 ml/day
• Total: 1000 ml + 50 ml = 1050 ml/day

Hourly Rate Calculation

• First 10 kg: 10 kg × 4 ml/kg/hour = 40 ml/hour
• Additional 1 kg: 1 kg × 2 ml/kg/hour = 2 ml/hour
• Total: 40 ml + 2 ml = 42 ml/hour

Clinical Considerations

Electrolyte Requirements

When administering maintenance fluids, appropriate electrolyte content should be included 1:

• Sodium: 1-3 mmol/kg/day
• Potassium: 1-3 mmol/kg/day
• Chloride: 2-4 mmol/kg/day

Fluid Type Selection

• Isotonic solutions (0.9% NaCl) are recommended for maintenance therapy in hospitalized children 3
• Hypotonic solutions should be avoided due to risk of hyponatremia 3

Important Caveats and Adjustments

The calculated maintenance fluid requirement may need adjustment in certain clinical scenarios:

1. Increased fluid needs:

   • Fever (increase by approximately 10-20% per degree Celsius above normal)
   • Hyperventilation
   • Hypermetabolism
   • Gastrointestinal losses 1

2. Decreased fluid needs:

   • Renal failure
   • Congestive heart failure
   • Critical illness
   • Mechanical ventilation 1

3. Special populations requiring fluid restriction:

   • Patients at risk for inadequate ADH secretion: restrict to 65-80% of calculated volume 3
   • Edematous states: restrict to 50-60% of calculated volume 3

Monitoring Parameters

When administering maintenance fluids, regular monitoring should include:

• Fluid balance (intake and output)
• Electrolyte levels
• Clinical status
• Body weight changes 1, 3

Practical Application

For this 11 kg girl, the 1050 ml/day (42 ml/hour) represents the baseline maintenance requirement. This calculation provides a starting point that should be adjusted based on the child's clinical condition, ongoing losses, and laboratory values.