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Racial Variation in Cerebral Near Infrared Spectroscopy Accuracy Among Infants in a Cardiac Intensive Care Unit

Marshall, C.; Diggs, S.; Pfeiffer, M.; Gerst, A.; Brumfiel, A.; Vesoulis, Z.

2025-04-22 pediatrics
10.1101/2025.04.21.25326146 medRxiv
Show abstract

ObjectivePulse oximeters overestimate arterial oxygen saturations in black versus white adults, children, and infants. While races 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 DesignA retrospective chart review was conducted for infants admitted to St. Louis Childrens Hospital CICU from 2017-2023. Bland-Altman plots, Pearson correlations, and mean biases were analyzed. Result254 infants (13% Black, 87% White) provided 3,687 central venous oxygen saturation (ScvO2)-cerebral regional oxygen saturation (rScO2) pairs. Measurement bias was -3.2% in Black infants and +0.1% in White infants (p<0.01). ConclusionCerebral NIRS underestimates ScvO2 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.

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