What is the formula for calculating maintenance fluid rates for pediatric patients weighing 10-20 kg?

The formula for calculating maintenance fluid rates in pediatric patients is guided by the "4-2-1 rule." For a child weighing between 10-20 kg, the appropriate rate is based on giving 100 ml/kg for the first 10 kg of body weight, followed by 50 ml/kg for the next 10 kg.

When considering a patient who falls within this weight range, the total maintenance needs are calculated as follows:

• For the first 10 kg: 10 kg x 4 ml/kg/hr = 40 ml/hr
• For the next 10 kg (if applicable): 10 kg x 2 ml/kg/hr = 20 ml/hr

Adding these together gives you a maintenance fluid rate of 60 ml/hr for a patient weighing 20 kg.

To find the rate on a per kg basis for patients in this weight range, dividing the total flow by the weight allows us to derive an average maintenance fluid rate. At the 20 kg mark, that works out to be around 3 ml/kg/hr.

The answer indicates 2 ml/kg/hr; this is a calculation based on patients weighted towards the lower end of the scale. While the average across all 10-20 kg may suggest