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Comparison of the Quantra QPlus System With Thromboelastography in Cardiac Surgery

Published:December 08, 2020DOI:https://doi.org/10.1053/j.jvca.2020.11.058

      Highlights

      • The Quantra Qplus System showed a strong to very strong correlation with the current standard of care (i.e. TEG5000 and conventional coagulation testing).
      • Comparable Quantra and TEG5000 test results are not directly interchangeable.
      • Initial Quantra results were available approximately 16.8 minutes earlier relative to corresponding TEG5000 results.

      Objectives

      Use of viscoelastic testing, such as thromboelastography (TEG), is recommended in cardiac surgery to monitor coagulation and to guide the transfusion of blood products. The Quantra QPlus System is a novel point-of-care platform that uses ultrasonic pulses to characterize dynamic changes in viscoelastic properties of a blood sample during coagulation. Despite the ability to assess similar aspects of clot formation, limited studies addressing the interchangeability of viscoelastic testing parameters exist. The primary aim of the present study was to assess the correlation and agreement between Quantra and TEG5000 results using blood samples from cardiac surgery patients.

      Design

      Tertiary care, academic medical center.

      Setting

      Prospective observational study.

      Participants

      Twenty-eight patients undergoing elective cardiac surgery undergoing cardiopulmonary bypass were evaluated.

      Measurements and Main Results

      Perioperative blood samples were collected and assessed using Quantra, and results were compared with TEG and conventional coagulation testing. Method comparison analysis demonstrated that Quantra parameters (Quantra clot time, clot stiffness, and fibrinogen contribution to clot stiffness) significantly correlated with TEG R and TEG G after induction of anesthesia, during cardiopulmonary bypass, and after rewarming (rs = 0.83, rs = 0.84, and rs = 0.73, respectively). However, Quantra parameters demonstrated poor agreement compared with equivalent TEG5000 parameters.

      Conclusions

      The Quantra QPlus System significantly correlated with TEG5000, suggesting that this test may be used in a similar clinical context. Despite the strength of correlation between Quantra and TEG parameters, measurements are not interchangeable.

      Key Words

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      Linked Article

      • Same Same but Different: Viscoelastic Hemostatic Assays in Cardiac Surgery
        Journal of Cardiothoracic and Vascular AnesthesiaVol. 35Issue 4
        • Preview
          VISCOELASTIC hemostatic assays (VHA) have become increasingly popular for monitoring perioperative coagulation status and guiding timely hemostatic therapy in cardiac surgery.1,2 VHA can be performed as point-of-care tests and might track perioperative coagulation disorders more accurately than standard coagulation tests.3,4 Implementation of VHA results in transfusion algorithms that have reduced the requirements of allogeneic blood products efficaciously in several studies and meta-analyses.5-7 Accordingly, the use of VHA is recommended by recent clinical guidelines in patient blood management and perioperative coagulation therapy in cardiac surgery.
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