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Dive into the research topics where David N. Herndon is active.

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Featured researches published by David N. Herndon.


Journal of Burn Care & Rehabilitation | 1998

Reduction in Mortality in Pediatric Patients with Inhalation Injury with Aerosolized Heparin/acetylcystine Therapy

Manu H. Desai; Ronald P. Mlcak; Richardson Ja; Ray J. Nichols; David N. Herndon

Smoke-inhalation injury causes a destruction of the ciliated epithelium that lines the tracheobronchial tree. Casts produced from these cells, polymorphonuclear leukocytes and mucus, can cause upper-airway obstruction, contributing to pulmonary failure. We have reported that a combination of aerosolized heparin and a mucolytic agent, N-acetylcystine [corrected], can ameliorate cast formation and reduce pulmonary failure secondary to smoke inhalation. In this study, 90 consecutive pediatric patients between 1985 and 1995 who had bronchoscopically diagnosed inhalation injury requiring ventilatory support were studied. Forty-three children admitted between 1985 and 1989 acted as controls. Forty-seven children admitted between 1990 and 1994 received 5000 units of heparin and 3 ml of a 20% solution of N-acetylcystine [corrected] aerosolized every 4 hours the first 7 days after the injury. All patients were extubated when they were able to maintain spontaneously a PaO2/FIO2 ratio of more than 400. The number of patients requiring reintubation for successive pulmonary failure was recorded, as was mortality. The results indicate a significant decrease in reintubation rates, in incidence of atelectasis, and in mortality for patients treated with the regimen of heparin and N-acetylcystine [corrected] when compared with controls. Heparin/N-acetylcystine [corrected] nebulization in children with massive burn injury and smoke-inhalation injury results in a significant decrease in incidence of reintubation for progressive pulmonary failure and a reduction in mortality.


Journal of Burn Care & Rehabilitation | 1997

Lung compliance, airway resistance, and work of breathing in children after inhalation injury

Ron Mlcak; Joaquin Cortiella; Manu H. Desai; David N. Herndon

Pathophysiologic changes associated with inhalation injury make mechanical ventilation in children a challenge. Decreased lung compliance and increased airway resistance after inhalation injury may lead to elevated airway pressures and barotrauma. Previous studies have shown significant decreases in the incidence of pneumonia and death in adult patients with inhalation injury treated with high-frequency percussive ventilation (HFPV) as compared with conventional mechanical ventilation (CMV). No studies to date have compared lung compliance, airway resistance, or work of breathing in children being treated with HFPV versus CMV. The purpose of this study was to evaluate lung compliance, airway resistance, and work of breathing in pediatric patients with inhalation injury who required mechanical ventilation. Ten children with bronchoscopically identified inhalation injury requiring mechanical ventilation were studied. Five children received CMV and five children received HFPV. All patients were treated according to our standard inhalation injury protocol. Based on our data and patient population, children receiving ventilation with the HFPV have a significant decrease in the work of breathing as compared with CMV.


Archive | 2009

Brandverletzungen bei Kindern

Ludwik K. Branski; David N. Herndon; Jong O. Lee; Marc G. Jeschke

Jedes Jahr gibt es in den USA ungefahr 1.25 Millionen Menschen, die Verbrennungen erleiden. Bei 40.000 dieser Menschen erweisen sich die Brandverletzungen als so schwer, dass sie stationar im Krankenhaus behandelt werden mussen. Rund 40% dieser Personen sind Kinder unter 15 Jahren. Bei dieser Personengruppe sind Brandverletzungen die dritthaufigste Verletzung mit Todesfolge, nach Autounfallen und Ertrinken. Jedes Jahr sterben namlich ungefahr 1800 Kinder an Brandverletzungen [1,2].


Archive | 2009

Die Pathophysiologie von Verbrennungswunden

Gerd G. Gauglitz; David N. Herndon; Lars-Peter Kamolz; Marc G. Jeschke

Brandverletzungen stellen weltweit ein erhebliches Problem dar. Obwohl die meisten dieser Verletzungen relativ leicht sind, ist z. B. in den USA bei 40.000 bis 60.000 Patienten jahrlich eine Einweisung in ein Krankenhaus oder in ein Verbrennungszentrum fur eine adaquate Behandlung notwendig [1]. Aktuellen Studien zufolge konnte innerhalb der letzten 20 Jahre eine Reduktion der stationaren Aufnahmen und eine 50% ige Senkung der Todesfalle infolge eines thermischen Traumas erreicht werden. Die Grunde dafur sind hauptsachlich wirksame Praventionsstrategien, durch die die Anzahl und der Schweregrad von Brandverletzungen gesenkt werden konnten [2,3]. Fortschritte bei den chirurgischen und intensivmedizinischen Therapiestrategien basieren auf einem besseren Verstandnis der pathophysiologischen Vorgange im Rahmen des thermischen Traumas. Dieses Kapitel soll das heutige Wissen zum Thema „Pathophysiologie der Verbrennungswunde“ darstellen und somit als Verstandnisgrundlage fur die Behandlung von Brandverletzten dienen.


Archive | 2009

Infektionen bei Brandverletzten

Gerd G. Gauglitz; David N. Herndon; Lars-Peter Kamolz; Marc G. Jeschke

Infektionen zahlen zu den haufigsten Todesursachen bei Brandverletzten. Bei Patienten mit Verbrennungen im Ausmas von mehr als 40% der Korperoberflache (Total Body Surface — TBSA) ist die Todesursache in 75% der Falle eine Infektion [1]. Durch viele Faktoren beeinflusst gestalten sich die Diagnose und die Behandlung von Infektionen bei Brandverletzten besonders schwierig. Brandverletzungen stellen die extremste Form von traumatischen Verletzungen dar und sind daher Ursache fur gravierende Veranderungen in den Abwehrmechanismen und der Immunfunktion der Opfer. Durch diese Veranderungen ist der Brandverletzte besonders anfallig fur Infektionen.


Total Burn Care (Fourth Edition) | 2012

Chapter 20 – Respiratory care

Ronald P. Mlcak; Sachin D Hegde; David N. Herndon


Journal of Burn Care & Rehabilitation | 2000

A Prospective Randomized Study of High Frequency Percussive Ventilation Compared to Conventional Mechanical Ventilation in Pediatric Patients with Inhalation Injury: 48.

Ronald P. Mlcak; Manubhai H. Desai; David N. Herndon


Journal of Burn Care & Rehabilitation | 2000

Inhalation Injury and Lung Function in Children a Decade Later: 43.

Ronald P. Mlcak; E. Robinson; Manubhai H. Desai; David N. Herndon


Total Burn Care (Fourth Edition) | 2012

Chapter 35 – Special considerations of age: The pediatric burned patient

Jong O. Lee; William B. Norbury; David N. Herndon


Journal of Burn Care & Rehabilitation | 2001

Does High Frequency Percussive Ventilation Result in Improved Pulmonary Function Compared to Conventional Mechanical Ventilation in Pediatric Burn Patients?: 24.

Ronald P. Mlcak; Oscar E. Suman; E. Robinson; S. Kiel; David N. Herndon

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Ronald P. Mlcak

University of Texas Medical Branch

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Celeste C. Finnerty

University of Texas Medical Branch

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Gabriela A. Kulp

University of Texas Medical Branch

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Manubhai H. Desai

University of Texas Medical Branch

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Joaquin Cortiella

University of Texas Medical Branch

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Jong O. Lee

University of Texas Medical Branch

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Manu H. Desai

Shriners Hospitals for Children

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Lars-Peter Kamolz

Medical University of Vienna

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David L. Chinkes

University of Texas Medical Branch

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