coagulation

Quantra Coagulation Guide

Interpret Quantra QPlus viscoelastic hemostatic assay results and guide coagulation therapy. Separate fibrinogen contribution (FCS) from platelet contribution (PCS) for targeted hemostatic resuscitation.

Based on: ESC 2022 · ESAIC

Input

Standard cartridge. Measures CT, CTH, CS, FCS, PCS.

Baseline assessment. Measures CT, CTH, CS, FCS, PCS. CTH enables heparin effect / factor deficiency differentiation via CT/CTH ratio.


Clot InitiationCT / CTH

Clotting time (reflects coagulation factor activity and heparin effect)

> 166 sec (consider preparing FFP)

CT with heparinase (neutralises heparin; reflects true factor activity)

ratio > 1.3 (prepare protamine)

Clot FirmnessCS / FCS / PCS

Clot stiffness (total clot firmness from fibrinogen + platelets)

13.0–16.0 hPa (clot stiffness declining)

Fibrinogen clot stiffness (fibrinogen contribution to clot firmness)

1.0–1.5 hPa (fibrinogen trending low)

Platelet clot stiffness (platelet contribution to clot firmness)

11.9–15.0 hPa (platelet contribution trending low)

Overview

Quantra (HemoSonics) measures blood clot mechanics using ultrasound resonance. Instead of tracking the rotation of pins or cups, Quantra detects how the stiffness of a blood sample changes as the clot forms. This allows the system to measure clot strength directly in physical units (hPa). The QPlus cartridge reports four key parameters: CT (Clotting Time — when clot formation begins), CS (total Clot Stiffness), FCS (Fibrinogen Contribution to Clot Stiffness), and PCS (Platelet Contribution to Clot Stiffness). By separating fibrinogen (FCS) from platelet contribution (PCS), Quantra allows clinicians to identify the dominant cause of weak clot formation and enables goal-directed haemostatic therapy without complex parameter interpretation.

Evidence Summary

Viscoelastic hemostatic assays (VHA) including Quantra have been validated in cardiac surgery and trauma for reducing allogeneic blood product transfusion while maintaining haemostatic safety. Quantra's sonic measurement technology provides real-time clot stiffness profiling. The FCS/PCS separation enables targeted therapy analogous to ROTEM FIBTEM and TEG CFF-MA. Current Quantra-specific evidence is emerging; general VHA evidence (ESA/ESAIC 2023, Class I) supports goal-directed haemostatic management in perioperative settings.

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