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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Article info
Publication history
Published online: December 08, 2020
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© 2020 Elsevier Inc. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Same Same but Different: Viscoelastic Hemostatic Assays in Cardiac SurgeryJournal of Cardiothoracic and Vascular AnesthesiaVol. 35Issue 4
- PreviewVISCOELASTIC 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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