Objectives
Viscoelastic tests allow a reduction in blood product transfusion. Three modern devices
are currently available (rotational thromboelastometry [ROTEM] sigma, thromboelastography
[TEG] 6S, and Quantra). No study has compared the performances of these 3 devices
simultaneously.
Design
An observational, nonrandomized cohort study.
Setting
A single-center of cardiac surgery in a university hospital.
Participants
A total of 30 consecutive measurements from at least 10 adult patients presenting
significant bleeding in the intensive care unit after cardiac surgery
Intervention
Viscoelastic tests using ROTEM sigma, TEG 6S, and Quantra were performed concomitantly
with conventional coagulation measurements
Measurements and Main Results
The authors included 16 patients with 31 blood samples. After the exclusion of missing
values, 27 samples were analyzed. Correlation with platelet count was as follows:
ROTEM, r = 0.84 [0.66-0.93], p < 0.0001; Quantra, r = 0.83 [0.64-0.92], p < 0.0001;
TEG 6S, r = 0.64 [0.29-0.83], p = 0.001. Correlation with fibrinogen (Clauss assay)
was as follows: ROTEM, r = 0.85 [0.68-0.93], p < 0.0001; Quantra, r = 0.88 [0.74-0.95],
p < 0.0001; TEG 6S, r = 0.79 [0.55-0.91], p < 0.0001. No difference was observed for
the detection of residual circulating heparin (anti-Xa activity >0.1), with 87% of
correct identification for Quantra and 80% for both ROTEM and TEG 6S (p = 0.3). Time
to first results after the beginning of the test was shorter for Quantra than ROTEM
and TEG 6S (136 [126-152] seconds v 205 [176-221] seconds, p = 0.003 and v 450 [372-516] seconds, p < 0.0001 respectively).
Conclusion
ROTEM sigma, TEG 6S, and Quantra performed similarly for exploring platelet count
or residual circulating heparin. Thromboelastography 6S presented a weaker correlation
with fibrinogen Clauss.
Key Words
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Article info
Publication history
Published online: February 21, 2023
Publication stage
In Press Corrected ProofIdentification
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