RESUMO
Major surgical procedures often result in significant intra- and postoperative bleeding. The ability to identify the cause of the bleeding has the potential to reduce the transfusion of blood products and improve patient care. We present a novel device, the Quantra Hemostasis Analyzer, which has been designed for automated, rapid, near-patient monitoring of hemostasis. The Quantra is based on Sonic Estimation of Elasticity via Resonance Sonorheometry, a proprietary technology that uses ultrasound to measure clot time and clot stiffness from changes in viscoelastic properties of whole blood during coagulation. We present results of internal validation and analytical performance testing of the technology and demonstrate the ability to characterize the key functional components of hemostasis.
Assuntos
Testes de Coagulação Sanguínea/instrumentação , Cuidados Críticos , Hemostasia , Reologia/instrumentação , Ultrassom/instrumentação , Automação , Coagulação Sanguínea , Testes de Coagulação Sanguínea/normas , Viscosidade Sanguínea , Calibragem , Módulo de Elasticidade , Desenho de Equipamento , Hemorreologia , Humanos , Valor Preditivo dos Testes , Padrões de Referência , Reprodutibilidade dos Testes , Reologia/normas , Fatores de Tempo , Ultrassom/normasRESUMO
BACKGROUND: The Quantra QPlus System is a novel viscoelastic testing (VET) device designed for the management of coagulation function in critical care settings. The system is indicated and approved for use at the point-of-care and designed for use by nonlaboratory personnel. METHODS: We describe the comprehensive set of internal QC checks implemented in the Quantra and demonstrate the system's unique capabilities made possible by its ultrasound core technology. Single- and multisite precision testing were performed following Clinical Laboratory Standards Institute guidelines and included multiple days of testing, multiple instruments, multiple lots of cartridges and controls, and multiple operators. RESULTS: Percent CVs for total imprecision were 3.6% to 8.0% for all measured parameters. CVs for replicate imprecision ("repeatability") were 2.7% to 7.7% for all measured parameters. Replicate imprecision was the largest component of variability for most parameters. CONCLUSIONS: 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.