Abstract Number: PB0080
Meeting: ISTH 2021 Congress
Theme: Coagulation and Natural Anticoagulants » Critical Care and Perioperative
Background: Coagulation point-of-care (POC) tests are commonly used for hemostasis monitoring during cardiac surgery. The Quantra® system is a new coagulation POC device based on Sonic Estimation of Elasticity via Resonance (SEER) Sonorheometry equipped with a disposable QPlus® 4-channels cartridge. QPlus® parameters have been shown to well correlate with conventional coagulation tests and rotational thromboelastometry parameters, but no prior study compared them to those obtained with the TEG®6s citrated and platelet mapping (PM) cartridges.
Aims: To compare the Quantra® QPlus® and the TEG®6s cartridges parameters for POC monitoring of hemostasis during cardiac surgery with cardiopulmonary bypass.
Methods: 21 patients were included in this cohort study. Blood was sampled before surgery, intraoperatively and 10 minutes after protamine administration. SEER Sonorheometry was performed on a Quantra® Hemostasis analyzer with the QPlus Cartridge (HemoSonics LLC) and thromboelastography on a TEG®6s Hemostasis Analyzer with the citrated and PM cartridges (Haemonetics).
Results: The median age was 60 (53-71) years, with a median BMI of 25 (23-27) Kg/m², and 15 (71%) patients were men. The median Euroscore was 2.9 (1.8-4.1). Quantra® parameters assessing clot stiffness (CS) significantly dropped over the course of cardiac surgery [CS (p<0.0001), fibrinogen contribution to CS (FCS, p=0.0001) and platelet contribution to CS (PCS, p<0.0001)]. Quantra® clot time significantly correlated with TEG®6-CK R-time (r=0.51), and Quantra® clot time with heparinase with TEG®6s-CKH R-time (r=0.73). Quantra® CS showed a strong correlation with TEG®6s CRT MA (r=0.88) and Quantra® FCS with both TEG®6s CFF-MA (r=0.86) and fibrinogen levels (r=0.74). Finally, Quantra® PCS weakly correlated with TEG®6s PM-AA (r=0.61), TEG®6s PM-ADP (r=0.45) and platelet count (r=0.57). However, Bland–Altman plots revealed a poor agreement between Quantra® QPlus and TEG®6s parameters.
Spearman rank correlations between Quantra® and TEG® 6s parameters. A: QPlus CT (sec) vs TEG®6s CK R-time (sec); B: QPlus CTH (sec) vs TEG®6s CKH R-time (sec); C: QPlus CS (hPa) vs TEG®6s CRT MA (hPA) ; D: QPlus FCS (hPa) vs TEG®6s CFF-MA (hPA) ; E: QPlus FCS (hPa) vs Fibrinogen (g/L) ; F: QPlus PCS (hPa) vs TEG®6s PM-AA (hPA) ; G: QPlus PCS (hPa) vs TEG®6s PM-ADP (hPA) ; H: QPlus PCS (hPa) vs platelet count (G/L).
Bland–Altman plots to evaluate the agreement between Quantra® and TEG® 6s parameters. A: QPlus CT (sec) vs TEG®6s CK R-time (sec); B: QPlus CTH (sec) vs TEG®6s CKH R-time (sec); C: QPlus CS (hPa) vs TEG®6s CRT MA (hPA) ; D: QPlus FCS (hPa) vs TEG®6s CFF-MA (hPA) ; E: QPlus FCS (hPa) vs Fibrinogen (g/L) ; F: QPlus PCS (hPa) vs TEG®6s PM-AA (hPA) ; G: QPlus PCS (hPa) vs TEG®6s PM-ADP (hPA) ; H: QPlus PCS (hPa) vs platelet count (G/L).
Conclusions: Despite acceptable correlations between the Quantra® and TEG®6s parameters, these measurements are not interchangeable.
To cite this abstract in AMA style:
Abbes A, Frere C, Loeb J, Djavidi N, Lebreton G, Bougle A. A Comparative Study of SEER Sonorheometry versus Thromboelastography during Cardiac Surgery with Cardiopulmonary Bypass [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/a-comparative-study-of-seer-sonorheometry-versus-thromboelastography-during-cardiac-surgery-with-cardiopulmonary-bypass/. Accessed November 27, 2021.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/a-comparative-study-of-seer-sonorheometry-versus-thromboelastography-during-cardiac-surgery-with-cardiopulmonary-bypass/