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

Werner Baulig; Samira Akbas; Philipp K Schütt; Wolfgang Keul; Marija Jovic; Pascal Berdat; Stefanie von Felten; Klaus Steigmiller; Michael Thomas Ganter; Oliver M Theusinger

doi:10.1186/s12871-021-01469-5

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

BMC Anesthesiol. 2021 Oct 28;21(1):260. doi: 10.1186/s12871-021-01469-5.

Authors

Affiliations

¹ Department of Anesthesiology and Intensive Care Medicine, Klinik Im Park, Seestrasse 220, CH-8027, Zurich, Switzerland. werner.baulig@hirslanden.ch.
² Institute of Anesthesiology, University Hospital, Zurich, Switzerland.
³ Department of Anesthesiology and Intensive Care Medicine, Klinik Im Park, Seestrasse 220, CH-8027, Zurich, Switzerland.
⁴ Department of Cardiac Surgery, Klinik Im Park, Zurich, Switzerland.
⁵ Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
⁶ Institute of Anesthesiology, Kantonsspital Winterthur, Winterthur, Switzerland.
⁷ Medical Department, OSEARA health care medicine, Kloten, Switzerland.

^# Contributed equally.

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.

Keywords: Quantra; ROTEM sigma, cardiac surgery; Resonance Sonorheometry; Viscoelastic testing.

Publication types

Comparative Study
Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Blood Coagulation*
Cardiac Surgical Procedures*
Elasticity
Female
Humans
Male
Monitoring, Intraoperative / instrumentation*
Prospective Studies
Rheology / instrumentation
Thrombelastography*
Ultrasonics / instrumentation*

Associated data

ClinicalTrials.gov/NCT04210830