Quantra

The study confirms that sonorheometry using the Quantra analyzer effectively monitors dabigatran reversal. Following idarucizumab administration, prolonged clot times significantly decreased and clot stiffness normalized within 30 minutes, correlating with reduced anti-IIa activity. These findings suggest that viscoelastic testing is a valuable bedside tool for rapidly assessing the efficacy of reversal therapy in patients with major bleeding.

"Quantra® provides a rapid assessment of haemostasis during LT."

The Quantra System represents a modern evolution in coagulation monitoring by replacing traditional mechanical "cup and pin" methods with innovative SEER Sonorheometry (ultrasound). This automated, cartridge-based approach significantly improves result reproducibility and simplifies specimen management, providing clinicians with a faster and more precise tool for guided transfusion therapy and hemotherapy.

"VETs assess dynamic aspects of hemostasis, regarding both clot formation and dissolution so allowing to evaluate a “dynamic” modification of hemostasis over time. They could provide to clinicians more information about the CAC, identifying at the patient bedside the presence of a hypercoagulable state and hypofibrinolysis, that are more evident than in coagulopathy during the sepsis. In regard to VTE prediction, the results of VETs analysis demonstrate a hypercoagulable state that is not predictive for thrombotic events in critically ill COVID-19 patients. The clinical application of VETs in patients with severe COVID-19 infection should be combined with biohumoral parameters (i.e. D-dimer). Future studies on large patient populations should define the usefulness of VETs as prognostic markers of micro- and macrothrombosis in severe COVID-19 patients to improve morbidity and mortality. The dynamic coagulative approach based on the use of VETs, associated to laboratory tests, might help to guide a personalized anticoagulant strategy, well knowing that “one size does not fit all”."

The study by Whyte et al. (2022) concludes that a fibrinogen supplement of 1 mg/mL effectively restores clot integrity in trauma-induced coagulopathy models. While both fibrinogen concentrates and cryoprecipitate improved hemostatic parameters, FibCLOT® and cryoprecipitate were superior to RiaSTAP® in normalizing fibrin structure and resisting lysis. This enhanced performance - particularly in FibCLOT® - is driven by significantly higher levels of Factor XIII (FXIII), which strengthens the clot against mechanical and enzymatic degradation. Ultimately, the co-infusion of FXIII within these preparations is a critical factor in achieving a stable, lysis-resistant clot.

"The obstetric complication AFE is rare but potentially fatal and its diagnosis of exclusion is based on clinical presentation. We present a case of AFE with profound coagulopathy, developed after cesarean section for placenta previa, complicated by severe PPH. This case highlights the use of the most recent POCVT device, the Quantra QStat® system, to acquire rapid, reliable, and actionable coagulopathy information during PPH management. Quantra QStat® testing allowed for early recognition of hypofibrinogenemia and guided fibrinogen replacement and blood transfusions. We suggest that POCVT can assist in the early diagnosis of developing obstetric coagulopathies and inform individualized blood product resuscitation. Further, the implementation of patient blood management measures may contribute to reducing maternal death and complications, as well as improving treatment efficiency."

"In summary, we can conclude from this study that the use of the Quantra® sonorheometry VET technique allows a global analysis of the hemostatic status of COVID-19 patients in a rapid and efficient way, including clot stiffness parameters (CS, PCS, FCS, CSL) that are not routinely measured by standard laboratory tests. The implementation of this technique would allow for a more accurate diagnosis of patients on admission, helping in patient triage. By using this technique, we were able to detect that COVID-19 patients with higher clot stiffness showed a worse prognosis, especially due to the higher contribution of fibrinogen (FCS). Although further studies are needed to confirm these findings, the combination of elevated FCS and D-dimer, was shown to be an independent prognostic factor for the risk of an adverse event during admission among COVID-19 patients, so the close monitoring of both parameters could be of interest for the management of these patients. This finding could also contribute to the development of new therapeutic strategies thanks to the numerous anticoagulant agents currently available."

"In a patient with hemophilia B, cardiac surgery with extracorporeal circulation was performed safely without hemorrhagic or thrombotic complications after a single preoperative dose of rIX‐FP. Viscoelastic tests proved to be very useful in monitoring the patient during surgery."

"This study identifies potential cutoff values for QPlus FCS and PCS proposed for use in place of or in conjunction with laboratory-based assays fibrinogen and platelet thresholds to guide transfusion decisions in surgical patients. These cut-off values will need to be validated in future studies."

"Quantra viscoelastic testing represents a promising advancement in point-of-care hemostasis management for pediatric trauma. Its simplicity, rapid turnaround, and strong correlation with established VHAs make it well-suited for integration into emergency and perioperative workflows. While early data are encouraging, further pediatric validation studies are essential to establish age-adjusted reference values and outcome-based transfusion thresholds. As part of a multidisciplinary trauma resuscitation strategy, Quantra has the potential to enhance precision transfusion, reduce blood product utilization, and improve outcomes in injured children. "

"Despite weaknesses in correlation and agreement both VET devices suggested appropriate coagulation management based on the simulated transfusion algorithms. Quantra and TEG-5000 are not interchangeable and none of them can be considered as "the gold standard"."

"QStat provides comparable information to the ROTEM delta and TEG 6s in trauma patients and can be useful for diagnosing TIC and guiding treatment. The Quantra's simplicity of use, ability to deploy at the POC, and rapid availability of results may provide clinicians with a faster, more convenient means to assess and manage TIC."

While new cartridge-based VHA devices simplify point-of-care testing, their clinical value is not yet fully established. Current research highlights a lack of interchangeability between devices and a shortage of data linking them to patient outcomes or comparing them to rapid conventional assays. Consequently, despite their technical promise, robust randomized clinical trials are still required to prove their utility in critical care settings.

This study confirms that the Quantra System with the QStat Cartridge is a highly reliable alternative to the ROTEM delta for monitoring hemostasis during liver transplantation. Showing strong correlation and over 90% agreement in detecting fibrinolysis, the Quantra provides comparable clinical data through a faster, more user-friendly interface. Its point-of-care efficiency makes it a valuable tool for optimizing transfusion management in critical surgical settings.

"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."

"Quantra and ROTEM have similar diagnostic performances in evaluating TIC and predicting clinically relevant outcomes. Larger studies are required to determine the utility of Quantra for goal-directed treatment of TIC."

Modern cartridge-based VET - specifically the TEG 6s, HemoSonics Quantra, and ROTEM sigma - offers superior portability and ease of use compared to traditional laboratory methods. Despite limited randomized evidence for these new-generation devices, VET-guided algorithms effectively reduce blood product usage without compromising patient outcomes. Future validation of clinical cut-offs will be key to optimizing transfusion management.

"Strong correlations were observed between quantra parameters FCS and PCS with Clauss Fibrinogen and Platelet count. While Performance from ROC curves for predicted thrombocytopenia <150k platelet/µL is similar with TEG-5000, they are better for predicted fibrinogen concentration and prolonged aPTT."

"Six patients were included in this preliminary analysis. The results are summarized in the table below The use of Quantra® significantly reduced the time required to obtain hemostasis results. Furthermore, the results were clinically consistent with those of standard lab testing, and earlier availability led to more rapid and targeted BP administration. This single-center preliminary study highlights the utility of the Quantra® device in pediatric cardiac surgery. Quantra® allows for faster access to coagulation data, enabling quicker and more targeted administration of blood products. These findings support its integration into intraoperative hemorrhagic management protocols."

"Implementation of a Quantra-based hemostatic algorithm was associated with a decrease in transfusion requirement and major bleeding after high-bleeding-risk cardiac surgery. Randomized trials are needed to confirm these results."

"Our results suggest that the SEER device can be used as a VET device for initial detection of blood coagulation test disorders in trauma patients. We found reasonable performances of the SEER device in detecting a aPTT ratio of >1.5, an INR of >1.5, a fibrinogen concentration of <1.5 g/L, and a platelet count of <50 G/L. However, the cutoff values that corresponded to the blood coagulation test disorders were within or close to the normal range of the SEER tests. Therefore, we conclude that the SEER device may be useful for detecting blood coagulation test abnormalities within a short period of time on admission of trauma patients but that threshold values should be interpreted with caution pending further prospective data."

"The use of point of care coagulation testing is effective in detecting incomplete reversal of heparin."

"Use of the Quantra QPlus System has the potential to improve patient blood management and decrease costs."

This study establishes the first pediatric reference ranges for the Quantra Hemostasis Analyzer, confirming that values for children aged 2–17 are comparable to those of adults. The device offers a significant advantage over traditional methods like TEG or ROTEM due to its automation and rapid results (under 15 minutes), supporting faster goal-directed transfusion decisions in pediatric surgery despite its higher blood volume requirement.

"The Quantra QPlus System is a new-generation cartridge-based VET device that can operate with reduced oversight from the central laboratory while easily integrating into the Individualized Quality Control Plan framework."

"This study demonstrates that Quantra clot stiffness-based parameters (CS, FCS, PCS) are unaffected by sampling site, whereas the clot time parameters (CT and CTH) show good correlation in the presence of a bias. CTR, a ratio of CT and CTH, also is unaffected."