Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 17;18(1):149.
doi: 10.1186/s13019-023-02245-x.

Retrospective study assessing outcomes in cardiac surgery after implementation of Quantra

Pierre Tibi  1 , Jess Thompson  2 , Saina Attaran  2 , Elizabeth Black  2
Affiliations

Retrospective study assessing outcomes in cardiac surgery after implementation of Quantra

Pierre Tibi et al. J Cardiothorac Surg. .

Abstract

Background: The Quantra QPlus System is a cartridge-based device with a unique ultrasound technology that can measure the viscoelastic properties of whole blood during coagulation. These viscoelastic properties correlate directly with hemostatic function. The primary objective of this study was to assess blood product utilization in cardiac surgery patients before and after the implementation of the Quantra QPlus System.

Methods: Yavapai Regional Medical Center implemented the Quantra QPlus System to aid in their efforts to reduce the transfusion of allogenic blood products and improve outcomes in patients undergoing cardiac surgery. A total of 64 patients were enrolled prior to the utilization of the Quantra (pre-Quantra cohort), and 64 patients were enrolled after (post-Quantra cohort). The pre-Quantra cohort had been managed via standard laboratory assays along with physician discretion for transfusion decisions. The utilization of blood products and frequency of transfusions were compared and analyzed between the two cohorts. (using the Student's t-test) RESULTS: The implementation of the Quantra resulted in a change in the pattern of blood product utilization leading to a demonstrated decrease in the amount of blood products transfused and the associated costs. The amount of FFP transfused was significantly decreased by 97% (P = 0.0004), whereas cryoprecipitate decreased by 67% (P = 0.3134), platelets decreased by 26% (P = 0.4879), and packed red blood cells decreased by 10% (P = 0.8027) however these trends did not reach statistical significance. The acquisition cost of blood products decreased by 41% for total savings of roughly $40,682.

Conclusions: Use of the Quantra QPlus System has the potential to improve patient blood management and decrease costs. STUDY REGISTERED AT CLINICALTRIALS.GOV: NCT05501730.

Keywords: Blood management; Cardiac surgery; Point-of-care testing, Quantra, Transfusion.

PubMed Disclaimer

Conflict of interest statement

Pierre Tibi, MD. reports funding from HemoSonics LLC in the way of speakers fees.

Figures

Fig. 1
Fig. 1
Quantra Treatment Guide Yavapai Regional Medical Center’s Quantra treatment guide utilized in cardiac surgical cases in the post-Quantra group. ACT: activated clotting time; CS: clot stiffness; CT: clot time; CTH: clot time with heparinase; CTR: Clot Time Ratio; DDAVP: desmopressin; FCS: fibrinogen contribution to clot stiffness; ICU: intensive care unit; ml: milliliter; PCS: platelet contribution to clot stiffness; Q1: baseline sample drawn in the operating room; Q2: sample taken while patient on cardiopulmonary bypass and body temperature at 35–37 degrees prior to cross clamp release; Q3: sample taken post protamine administration and after acute normovolemic hemodilution; Q4: Sampling done postoperatively; VET: viscoelastic testing
Fig. 2
Fig. 2
Blood Product Utilization A. Total units of blood products utilized during the hospital stay for the two study cohorts. B. Utilization of blood products in the intra- and post-operative time periods *Statistically significant p < 0.05 FFP: Fresh frozen plasma; pRBC: Packed red blood cells
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Raphael J, Mazer CD, et al. Society of Cardiovascular Anesthesiologists clinical practice improvement advisory for management of perioperative bleeding and hemostasis in cardiac surgery patients. J Cardiothorac Vasc Anesth. 2019;33(11):2877–99. doi: 10.1053/j.jvca.2019.04.003. - DOI - PubMed
    1. Murphy GJ, Reeves BC et al. (2007). Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation. 2017; 116(22), 2544–2552. - PubMed
    1. Kozek-Langenecker S. Management of massive operative blood loss. Minerva Anesthesiol. 2007;73:401–15. - PubMed
    1. Despotis G, Eby C, Lublin DM. A review of transfusion risks and optimal management of perioperative bleeding with cardiac surgery. Transfusion. 2008;48:2S–30S. doi: 10.1111/j.1537-2995.2007.01573.x. - DOI - PubMed
    1. American Society of Anesthesiologists Task Force on Perioperative Blood Management Practice guidelines for perioperative blood management: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Management. Anesthesiology. 2015;122:241–75. doi: 10.1097/ALN.0000000000000463. - DOI - PubMed

Associated data