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RecruitingNCT07823569Updated Sep 16, 2026

Effect of Prone Position on Continuous Noninvasive Hemoglobin Measurement

An observational study in Lumbar Stabilization Surgery and Noninvasive Hemoglobin Monitoring, sponsored by Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-16.

Sponsored by Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
80
Ages
18 Years and older
Sex
All
01

Study summary

This prospective observational study aims to evaluate whether the prone position affects the agreement between noninvasive hemoglobin (SpHb) measurements and laboratory hemoglobin values in patients undergoing lumbar stabilization surgery under general anesthesia.

SpHb provides continuous, noninvasive monitoring of hemoglobin using multi-wavelength pulse CO-oximetry. However, its accuracy may be affected by changes in peripheral perfusion, hemodynamic status, and patient position. The prone position used during spine surgery may alter cardiovascular function and peripheral perfusion and may therefore influence SpHb measurements.

In this study, SpHb values obtained in the supine and prone positions will be compared with simultaneously obtained laboratory hemoglobin values. The study will also evaluate the ability of SpHb to follow changes in hemoglobin during surgery. The results may help clarify the clinical usefulness of continuous noninvasive hemoglobin monitoring during surgery performed in the prone position.

Read the detailed description

This is a prospective, single-center observational study involving adult patients undergoing lumbar stabilization surgery under general anesthesia. Eligible patients will be older than 18 years and classified as American Society of Anesthesiologists (ASA) physical status I-III.

During surgery, noninvasive hemoglobin concentration (SpHb) will be monitored using a pulse CO-oximetry sensor placed on the finger as part of intraoperative monitoring. SpHb measurements will be compared with laboratory hemoglobin values obtained from blood gas analysis. Measurements obtained during supine and prone positioning will be evaluated to determine whether prone positioning affects the agreement between noninvasive and laboratory hemoglobin measurements.

Demographic and clinical characteristics, intraoperative hemodynamic variables, laboratory and blood gas parameters, estimated intraoperative blood loss, amount of transfused blood products, postoperative intensive care unit stay, and total hospital length of stay will also be recorded. The study will additionally assess the potential of SpHb for following intraoperative hemoglobin trends.

02

Conditions studied

  • Lumbar Stabilization Surgery
  • Noninvasive Hemoglobin Monitoring

Keywords

  • Prone Position
  • Noninvasive Hemoglobin Monitoring
  • SpHb
  • Laboratory Hemoglobin
  • Pulse CO-Oximetry
  • Perioperative Monitoring
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Adult patients undergoing elective lumbar stabilization surgery under general anesthesia at Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital. Eligible participants will have an ASA physical status of I-III and will undergo intraoperative noninvasive hemoglobin (SpHb) monitoring together with laboratory hemoglobin measurements.

Inclusion criteria

  • Age 18 years or older
  • American Society of Anesthesiologists (ASA) physical status I-III
  • Scheduled to undergo lumbar stabilization surgery under general anesthesia
  • Provision of written informed consent for participation in the study

Exclusion criteria

Exclusion Criteria:

  • Refusal to participate in the study
  • ASA physical status IV-V
  • Hemoglobin level \<10 g/dL
  • Presence of peripheral arterial disease
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
80 participants (estimated)
Patient registry
No

Groups and cohorts

  • Patients Undergoing Lumbar Stabilization Surgery

    Adult patients undergoing lumbar stabilization surgery under general anesthesia. Noninvasive hemoglobin (SpHb) and laboratory hemoglobin measurements will be obtained and compared during supine and prone positioning.

    Other: Prone Positioning

Interventions

  • OtherProne Positioning

    Prone positioning is performed as part of standard surgical care for lumbar stabilization surgery and is not assigned by the investigators. The study will evaluate the association between prone positioning and the agreement between noninvasive hemoglobin (SpHb) measurements and simultaneously obtained laboratory hemoglobin values.

05

What researchers measure

Primary outcomes

  1. Agreement Between Noninvasive Hemoglobin (SpHb) and Laboratory Hemoglobin Measurements

    Paired noninvasive hemoglobin (SpHb) and laboratory hemoglobin values will be obtained at corresponding intraoperative time points in the supine and prone positions. The primary outcome is the agreement between SpHb and laboratory hemoglobin measurements and whether this agreement changes after positioning the patient prone.

    Time frame: Intraoperative period, during supine and prone positioning on the day of surgery

Secondary outcomes

  1. Ability of SpHb to Track Intraoperative Hemoglobin Changes

    Changes in noninvasive hemoglobin (SpHb) measurements over the intraoperative period will be compared with corresponding changes in laboratory hemoglobin values to evaluate the ability of SpHb to track the direction and magnitude of hemoglobin changes during surgery.

    Time frame: Intraoperative period on the day of surgery

06

Study locations

1 of 1 sites recruiting
  • Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital
    Istanbul, Istanbul 34000, Turkey (Türkiye)
    Recruiting
07

References and documents

Publications

  • Tang B, Yu X, Xu L, Zhu A, Zhang Y, Huang Y. Continuous noninvasive hemoglobin monitoring estimates timing for detecting anemia better than clinicians: a randomized controlled trial. BMC Anesthesiol. 2019 May 17;19(1):80. doi: 10.1186/s12871-019-0755-1. PubMed 31101083 ↗
  • Berkow L, Rotolo S, Mirski E. Continuous noninvasive hemoglobin monitoring during complex spine surgery. Anesth Analg. 2011 Dec;113(6):1396-402. doi: 10.1213/ANE.0b013e318230b425. Epub 2011 Sep 29. PubMed 21965372 ↗
  • Park SK, Hur C, Kim YW, Yoo S, Lim YJ, Kim JT. Noninvasive hemoglobin monitoring for maintaining hemoglobin concentration within the target range during major noncardiac surgery: A randomized controlled trial. J Clin Anesth. 2024 May;93:111326. doi: 10.1016/j.jclinane.2023.111326. Epub 2023 Nov 20. PubMed 37988814 ↗
  • Adel A, Awada W, Abdelhamid B, Omar H, Abd El Dayem O, Hasanin A, Rady A. Accuracy and trending of non-invasive hemoglobin measurement during different volume and perfusion statuses. J Clin Monit Comput. 2018 Dec;32(6):1025-1031. doi: 10.1007/s10877-018-0101-z. Epub 2018 Jan 15. PubMed 29335914 ↗
  • Erdogan Kayhan G, Colak YZ, Sanli M, Ucar M, Toprak HI. Accuracy of non-invasive hemoglobin monitoring by pulse CO-oximeter during liver transplantation. Minerva Anestesiol. 2017 May;83(5):485-492. doi: 10.23736/S0375-9393.17.11652-4. Epub 2017 Jan 20. PubMed 28106356 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT07823569
Lead sponsor
Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital
Responsible party
Sponsor
First posted
Sep 16, 2026
Start date
Sep 11, 2026
Primary completion
Dec 31, 2026 (estimated)
Completion
Dec 31, 2026 (estimated)
Last update
Sep 16, 2026

Study contacts

Şule Altuncu, MD
Contact
sancaktepeetikkurul@gmail.com
02166063300
Altuncu
principal investigator · Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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