• Arsalan Derakhshan, Reza Manesh, Bennett A Peterson, Bibhu D Mohanty, Thomas S Kickler, and Daniel J Brotman.
• Department of Internal Medicine, Case Western Reserve University School of Medicine, University Hospital Cleveland Medical Center, Cleveland, Ohio.
• J Hosp Med. 2021 Apr 1; 16 (4): 219-222.

AbstractA patient's supine posture redistributes plasma into the vascular space, leading to dilution of blood constituents. The extent to which posture may influence identification of hospital-acquired anemia is unknown. Patients in this quasi-experimental study had blood obtained for hemoglobin measurement while recumbent for at least 6 hours, and then again after sitting upright for at least 1 hour. Of the 35 patients who completed the study, 13 were women (37%). Patients had a median increase in hemoglobin of 0.60 g/dL (range, -0.6 to 1.4 g/dL) with sitting, a 5.2% (range, (-4.5% to 15.1%) relative change (P < .001). Ten of 35 patients (29%) exhibited an increase in hemoglobin of 1.0 g/dL or more. Posture influences hemoglobin levels in hospitalized patients on general medicine wards; this knowledge may help curb unnecessary testing to evaluate small changes in hemoglobin concentration.

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