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325: BARRIERS AND FACILITATORS OF HIGH-QUALITY RCTS IN PEDIATRIC CRITICAL CARE: A SURVEY OF TRIALISTS

Crit Care Med 2015 • Volume 43 • Number 12 (Suppl.) databases, Pediatric Health Information System (PHIS), and Organ Procurement and Transplantation Network (OPTN) registry (2004–2013). Methods: Using a linked database, we collected average annual case volume for the following variables: heart transplant, cardiac surgery, high complexity cardiac operations, extracorporeal membrane oxygenation (ECMO), cardiopulmonary bypass, mechanical ventilators, hospital discharges, nitric oxide, dialysis, acquired heart disease (myocarditis and cardiomyopathy), cardiac arrest, congestive heart failure, wait list, and organs recovered. Centers were divided in three categories based on the number of annual heart transplant cases performed. Multivariable logistic regression models were fitted to evaluate association of varied center volume variables and high-volume pediatric heart transplantation. Results: Overall, 25 centers qualified for inclusion. The average heart transplant cases in low-volume centers were 2 cases per year (IQR: 0–3), medium-volume centers were 10 cases per year (IQR: 7–13), and high-volume centers were 14 cases per year (IQR: 12– 19). Prior to adjustment, majority of center level variables had a positive association with high-volume pediatric heart transplantation. However, after adjusting for confounding factors, there was no association of high-volume pediatric heart transplantation with majority of center volume variables. The only center variable associated with high-volume pediatric heart transplantation was the number of patients waiting for heart transplantation (Coefficient: 7.92, 95% Confidence Interval: 7.108.75). Conclusions: In this large multi-center study, we conclude that high-volume pediatric heart transplant centers are not associated with high numbers of cardiac surgeries, high numbers of high-complexity cardiac operations, or high volumes of patients treated for acquired heart disease.