Quantra® Viscoelastic Testing in Pediatric Trauma: A Review of Emerging Evidence and Clinical Integration
Chris Deskins1, Samantha Smith1, Patrick C Bonasso2
1Anesthesiology, West Virginia University, Morgantown, USA.
Insights
Early recognition of trauma-induced coagulopathy (TIC) in children is vital. The Quantra system offers rapid viscoelastic hemostatic assay (VHA) assessment, potentially improving pediatric trauma resuscitation, though further validation is needed.
Area of Science:
- Traumatology
- Hemostasis
- Point-of-care diagnostics
Background:
- Trauma-induced coagulopathy (TIC) significantly impacts pediatric survival rates.
- Conventional coagulation tests (PT/INR, fibrinogen) offer delayed and incomplete assessments.
- Rapid, comprehensive coagulation monitoring is crucial for effective pediatric trauma management.
Purpose of the Study:
- To review the current evidence on the Quantra® System's utility in pediatric trauma.
- To compare Quantra® with established viscoelastic hemostatic assays (VHAs) like TEG® and ROTEM®.
- To discuss the emerging role of Quantra® in perioperative care and trauma resuscitation.
Main Methods:
- Literature review of studies involving Quantra® use in pediatric trauma.
- Comparative analysis of Quantra® data with conventional VHAs (TEG®, ROTEM®).
- Examination of preliminary data on Quantra®'s application in clinical settings.
Main Results:
- The Quantra® System provides a rapid, simple, and standardized assessment of coagulation.
- Preliminary data shows good correlation between Quantra® and conventional VHAs.
- Quantra® offers a potentially faster alternative for assessing coagulation in pediatric trauma.
Conclusions:
- The Quantra® System shows promise for real-time coagulation assessment in pediatric trauma resuscitation.
- Further large-scale pediatric validation studies are essential.
- Optimizing transfusion algorithms and assessing patient outcomes require further research.
Abstract:
Early recognition and correction of trauma-induced coagulopathy (TIC) are critical determinants of survival in pediatric trauma. Traditional laboratory evaluations, such as prothrombin time (PT)/international normalised ratio (INR) and fibrinogen, provide a delayed and incomplete assessment of real-time clotting behavior. The Quantra® System (HemoSonics, Charlottesville, VA, USA), a type of viscoelastic hemostatic assay (VHAs), utilizes soundwave technology to provide a more rapid and comprehensive assessment of coagulation. This review summarizes current evidence regarding Quantra use in pediatric trauma, compares it with conventional viscoelastic tools (TEG® (Haemonetics, Boston, MA, USA) and ROTEM® (Werfen, Bedford, MA, USA)), and discusses emerging experience in perioperative monitoring and trauma resuscitation pathways. Though preliminary data suggests Quantra is well-correlated with conventional VHAs and offers rapid, simple, and standardized assessment in pediatric trauma resuscitation, large-scale pediatric validation studies are needed to define thresholds, optimize transfusion algorithms, and assess outcomes.
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