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A Comparative Study of SEER Sonorheometry versus Thromboelastography during Cardiac Surgery with Cardiopulmonary Bypass

A. Abbes1, C. Frere1,2, J. Loeb1, N. Djavidi1, G. Lebreton1,2, A. Bougle1,3

1Assistance Publique Hôpitaux de Paris, Paris, France, 2Sorbonne Université, INSERM UMRS_1166, Institute of Cardiometabolism and Nutrition, Paris, France, 3Sorbonne Université, GRC 29, Paris, France

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 May 20, 2022.

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