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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]
For example, a person weighing 75 kg with burns to 20% of his or her body surface area would require 4 x 75 x 20 = 6,000 mL of fluid replacement within 24 hours. The first half of this amount is delivered within eight hours from the burn incident, and the remaining fluid is delivered in the next 16 hours. [6]
The majority of fluid output occurs via the urine, approximately 1500 ml/day (approx 1.59 qt/day) in the normal adult resting state. [12] [13] Some fluid is lost through perspiration (part of the body's temperature control mechanism) and as water vapor in exhaled air. These are termed "insensible fluid losses" as they cannot be easily measured.
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This occurs when these over-concentrated solutions sit in the gut and draw water from the rest of the body, and the reduced fluids in the body's tissues then have a higher proportion of salt to fluid. Children with serum sodium greater 150 mmol/liter have thirst out of proportion to other signs of dehydration.