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回顾性研究评估了 Quantra 实施后心脏手术的结果。

Retrospective study assessing outcomes in cardiac surgery after implementation of Quantra.

机构信息

Department of Cardiovascular Surgery, Yavapai Regional Medical Center, 811 Ainsworth Drive, Suite 109, Prescott, AZ, 86301, USA.

出版信息

J Cardiothorac Surg. 2023 Apr 17;18(1):149. doi: 10.1186/s13019-023-02245-x.

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.

摘要

背景

Quantra QPlus 系统是一种基于墨盒的设备,具有独特的超声技术,可在凝血过程中测量全血的粘弹性特性。这些粘弹性特性与止血功能直接相关。本研究的主要目的是评估 Quantra QPlus 系统实施前后心脏手术患者的血液制品使用情况。

方法

Yavapai Regional Medical Center 实施了 Quantra QPlus 系统,以帮助减少异体血液制品的输注,并改善接受心脏手术患者的预后。共有 64 名患者在使用 Quantra 之前(前 Quantra 队列)和 64 名患者之后(后 Quantra 队列)入组。前 Quantra 队列的管理采用标准实验室检测以及医生决定输血。比较并分析了两组之间的血液制品使用情况和输血频率。(使用学生 t 检验)

结果

Quantra 的实施改变了血液制品的使用模式,导致输注的血液制品数量和相关成本显著减少。FFP 的输注量显著减少了 97%(P=0.0004),而冷沉淀减少了 67%(P=0.3134),血小板减少了 26%(P=0.4879),浓缩红细胞减少了 10%(P=0.8027),但这些趋势没有达到统计学意义。血液制品的采购成本降低了 41%,总节省约 40682 美元。

结论

使用 Quantra QPlus 系统有可能改善患者的血液管理并降低成本。研究在 ClinicalTrials.gov 注册:NCT05501730。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e20/10111742/ef15552500bc/13019_2023_2245_Fig1_HTML.jpg

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