Evaluation of Quantra® Hemostasis Analyzer as a point-of-care device in obstetric patients at hemorrhage risk
Palleschi,
2, G.
1 Reyes,O. ,
Background •
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Dowling,
1Donald
2 O. ,
Allaiev,
2 A. ,
Sharma,
3 R. ,
Budis,
2 E. ,
and Shore-Lesserson,
and Barbara Zucker School of Medicine at Hofstra/Northwell 2Department of Anesthesiology Northshore University Hospital 3Department of OB/GYN Northshore University Hospital
Results
Rapid assessment of hemostatic function has significant clinical utility in obstetrics for the management of coagulopathies and safe level of hemostasis for regional 1,2 anesthesia Point-of-care (POC) hemostatic monitoring has been described using thromboelastography (TEG®) and rotational thromboelastometry (ROTEM®) Quantra® is a novel device that uses sonorheometry ultrasound technology to detect changes in viscoelastic properties 3 of blood Goal: To assess the utility of the Quantra® and correlation of Quantra® parameters with ROTEM® delta in obstetric patients at high risk of hemorrhage
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Patients (n=32) presenting for labor and delivery and at high risk of peripartum hemorrhage were enrolled Prospective, observational study Samples for Quantra® and ROTEM® were collected at baseline and postintervention, if appropriate Pearson or Spearman’s correlation coefficients of analogous parameters of Quantra® and ROTEM® were determined
Conclusions • •
Metrics from Quantra® strongly correlate with those from currently used viscoelastic testing device (ROTEM®) Quantra® may be used to guide hemostatic therapy in obstetric patients at high risk for hemorrhage
Future Direction •
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Methods •
1,2 L.
Quantra® parameters have similar clinical value to those provided by ROTEM® and can help inform optimal care and prevention in obstetrical coagulopathies Treatment algorithms incorporating Quantra® testing in the management of maternal 4,5,6 hemorrhage may optimize care , reducing bleeding and the volume of blood products transfused Use of Quantra® in viscoelastic POC testing 2,4 may contribute to greater cost efficiency in the management of maternal coagulopathies
Resources Figure 7: Independent CRISPR knockout of CDK4 or CDK6 does not cause dropout in most breast cancer cell lines studied.
Figure 1. Statistically significant correlations in analogous measurement parameters between Quantra® and ROTEM®
1. Hildyard, C. and N. Curry, Point-of-care testing: a standard of care? Anaesthesia, 2015. 70(10): p. 1113-8. 2. De Lange, N.M., et al., Obstetric hemorrhage and coagulation: an update. Thromboelastography, thromboelastometry, and conventional coagulation tests in the diagnosis and prediction of postpartum hemorrhage. Obstet Gynecol Surv, 2012. 67(7): p. 426-35. 3. Corey, F.S. and W.F. Walker, Sonic Estimation of Elasticity via Resonance: A New Method of Assessing Hemostasis. Ann Biomed Eng, 2016. 44(5): p. 1405-24. 4. Snegovskikh, D., et al., Point-of-care viscoelastic testing improves the outcome of pregnancies complicated by severe postpartum hemorrhage. J Clin Anesth, 2018. 44: p. 50-56. 5. Mallaiah, S., et al., Introduction of an algorithm for ROTEM-guided fibrinogen concentrate administration in major obstetric haemorrhage. Anaesthesia, 2015. 70(2): p. 166-75. 6. McNamara, H., et al., Four years' experience of a ROTEM((R)) -guided algorithm for treatment of coagulopathy in obstetric haemorrhage. Anaesthesia, 2019. 74(8): p. 984-991.