Publications by authors named "Patricia J Williams"
To quantify current protein prescription and delivery in critically ill adults in Australia and New Zealand and compare it with international guidelines. Prospective, multicentre, observational study. Five intensive care units (ICUs) across Australia and New Zealand.
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- The study analyzed the cost-effectiveness of early goal-directed therapy (EGDT) versus usual care for patients with early septic shock across 19 hospitals in Australia and New Zealand.
- It involved 205 patients, collecting data on healthcare costs, clinical outcomes like lives saved and quality-adjusted life-years (QALYs) over a 12-month period.
- The findings revealed that EGDT had higher costs and lower effectiveness than usual care, making it not cost-effective, with a low probability of being so based on the willingness-to-pay threshold.
Study protocol for TARGET protein: The effect of augmented administration of enteral protein to critically ill adults on clinical outcomes: A cluster randomised, cross-sectional, double cross-over, clinical trial.
Crit Care Resusc
September 2023
Article Synopsis
- The TARGET Protein trial will assess whether increasing dietary protein intake in ICU patients, as recommended by international guidelines, leads to better health outcomes compared to current practices.
- This clinical trial involves eight ICUs in Australia and New Zealand, where each ICU will switch between two different enteral nutrition formulas over a period of 12 months.
- The main goal is to see if higher protein intake reduces the number of days patients spend in the hospital and improves survival rates at 90 days post-admission.
Objective: Optimal resuscitation of sepsis-induced hypotension is uncertain, particularly the role of restrictive fluid strategies, leading to variability in usual practice. The objective of this study is to understand resuscitation practices in patients presenting to ED with early sepsis.
Methods: Design, participants and setting: Prospective, observational, multicentre, single-day, point-prevalence study enrolling adult patients present in 51 Australian and New Zealand ICUs at 10.
Use of a High-Protein Enteral Nutrition Formula to Increase Protein Delivery to Critically Ill Patients: A Randomized, Blinded, Parallel-Group, Feasibility Trial.
JPEN J Parenter Enteral Nutr
May 2021
Background: International guidelines recommend critically ill adults receive more protein than most receive. We aimed to establish the feasibility of a trial to evaluate whether feeding protein to international recommendations would improve outcomes, in which 1 group received protein doses representative of international guideline recommendations (high protein) and the other received doses similar to usual practice.
Methods: We conducted a prospective, randomized, blinded, parallel-group, feasibility trial across 6 intensive care units.
Aims: To evaluate the effect of energy-dense vs routine enteral nutrition on day-90 mortality by ethnic group in critically ill adults.
Methods: Pre-planned subgroup analysis of the 1,257 New Zealanders in a 4,000-participant randomised trial comparing energy-dense enteral nutrition (1.5kcal/mL) with routine enteral nutrition (1kcal/mL) in mechanically ventilated intensive care unit (ICU) patients.
Objectives: To examine long-term survival and quality of life of patients with early septic shock.
Design: Prospective, randomized, parallel-group trial.
Setting: Fifty-one hospitals in Australia, New Zealand, Finland, Hong Kong, and the Republic of Ireland.
Background: Gene expression regulation is one of the fundamental mechanisms of phenotypic plasticity and is expected to respond to selection in conditions favoring phenotypic response. The observation that many organisms increase their stress tolerance after acclimation to moderate levels of stress is an example of plasticity which has been long hypothesized to be based on adaptive changes in gene expression. We report genome-wide patterns of gene expression in two heat-tolerant and two heat-sensitive parthenogenetic clones of the zooplankton crustacean Daphnia pulex exposed for three generations to either optimal (18°C) or substressful (28°C) temperature.
View Article and Find Full Text PDFBackground: Critically ill patients typically receive ∼60% of estimated calorie requirements.
Objectives: We aimed to determine whether the substitution of a 1.5-kcal/mL enteral nutrition solution for a 1.