Racial Variation in Cerebral Near Infrared Spectroscopy Accuracy Among Infants in a Cardiac Intensive Care Unit
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Objective
Pulse oximeters overestimate arterial oxygen saturations in black versus white adults, children, and infants. While race’s impact on near-infrared spectroscopy (NIRS) accuracy is less studied, some adult research suggests decreased accuracy in black patients. This study investigates the effect of race on NIRS accuracy in infants in a cardiac intensive care unit (CICU).
Study Design
A retrospective chart review was conducted for infants admitted to St. Louis Children’s Hospital CICU from 2017-2023. Bland-Altman plots, Pearson correlations, and mean biases were analyzed.
Result
254 infants (13% Black, 87% White) provided 3,687 central venous oxygen saturation (ScvO 2 )-cerebral regional oxygen saturation (rScO 2 ) pairs. Measurement bias was −3.2% in Black infants and +0.1% in White infants (p<0.01).
Conclusion
Cerebral NIRS underestimates ScvO 2 in Black infants but maintains minimal measurement bias in White infants. This is the first study to assess race and NIRS accuracy in infants; the difference is statistically significant but not clinically relevant in most contexts.
