Comparison of the resonance sonorheometry based Quantra® system with rotational thromboelastometry ROTEM® sigma in cardiac surgery – a prospective observational study

Abstract

Background Measures of the sonorheometry based Quantra® viscoelastic hemostatic analyzer (HemoSonics, LCC, Charlottesville, VA, USA) were compared with corresponding results of the ROTEM® sigma device (Instrumentation Laboratory, Bedford, MA, USA). Methods In thirty-eight patients scheduled for elective cardiac surgery between December 2018 and October 2019, blood samples were taken after induction of anesthesia (sample 1) and after heparin neutralization (sample 2) and measured on Quantra (QPlus® Cartridge) and ROTEM sigma (ROTEM® sigma complete + hep Cartridge). Clot times and clot stiffness values were recorded. Clot stiffness values of ROTEM amplitudes (A in mm) were converted to shear modulus (G) in hectoPascal (hPa): G (hPa) = (5 x A)/(100-A). Additionally, time-to-results was recorded. Spearman rank test correlation and Bland Altman analysis were performed. Results Clot stiffness parameters of the Quantra correlated strongly with corresponding measurements of the ROTEM with r = 0.93 and 0.94 for EXTEM A10 vs CS and r = 0.94 and 0.96 for FIBTEM A10 vs FCS for sample 1 and 2, respectively. Quantra clot time correlated strongly with ROTEM INTEM CT with r = 0.71 for sample 1 and r = 0.75 for sample 2. However, Bland Altman analysis showed no agreement in all compared assays of both methods. The median time to delivery of first and complete results was significantly shorter for Quantra (412 and 658 s) compared to ROTEM sigma (839 and 1290 s). Conclusions The Quantra showed a strong correlation with the ROTEM sigma for determining clot times and clot stiffness and the parameters assess similar aspects of clot development. However, these parameters are not directly interchangeable and implicate that separate cut-off values need to be established for users of the Quantra device. Word count: 278. Trial registration The study was retrospectively registered with ClinicalTrials.gov (ID: NCT04210830) at December 20th 2019.

Are Viscoelastic Tests Clinically Useful to Identify Platelet-Dependent Bleeding in High-Risk Cardiac Surgery Patients?

“…QUANTRA is a novel device that has been validated for correlation with other VET in various studies. [20][21][22][23][24] The PCS parameter correlates with platelet count 22 and function. 23 In our series, the post-CPB QUANTRA PCS was the only independent factor associated with major bleeding once corrected for platelet count.…”

Reply to Spiess, B.D.; Houdijk, W.P.M. Comment on “Saner et al. The Yin and the Yang of Hemostasis in End-Stage Liver Disease. J. Clin. Med. 2023, 12, 5759”

“…We agree that the Quantra ® system, which uses ultrasound resonance to directly measure the physical strength of blood as it changes from a liquid to a gel, is a significant development in the field of coagulation analysis [2,5]. It provides a rapid, cartridge-based, point-of-care (POC) VET system that has shown promising results in various clinical settings, including for liver transplantation [2,5].…”

Multichannel Resonant Acoustic Rheometry System for Rapid and Efficient Quantification of Human Plasma Coagulation

“…For example, sonic estimation of elasticity via resonance (SEER) is a rheological method that addresses this drawback of contact-based techniques by utilizing ultrasound technology. Quantra ® is a fully-automated, ultrasound-based test that uses dry reagents, thus simplifying quality assurance and improving reproducibility 12 , 24 , 25 . However, these VHAs require expensive systems and reagents that are not readily available at every institution that could benefit from these devices.…”