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Racial Variation in Cerebral Near-Infrared Spectroscopy Accuracy among Infants in a Cardiac Intensive Care Unit.

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Summary

Near-infrared spectroscopy (NIRS) accuracy in infants shows racial bias. Black infants experienced an underestimate of cerebral oxygen saturation, unlike White infants, though the difference was not clinically significant.

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Area of Science:

  • Biomedical Engineering
  • Medical Physics
  • Neonatal Medicine

Background:

  • Pulse oximetry exhibits racial bias, overestimating arterial oxygen saturation in Black patients.
  • Limited research exists on race's impact on near-infrared spectroscopy (NIRS) accuracy, particularly in infants.

Purpose of the Study:

  • To investigate the effect of race on the accuracy of cerebral NIRS in infants within a cardiac intensive care unit (CICU).

Main Methods:

  • Retrospective chart review of infants in a CICU from 2017-2023.
  • Analysis of central venous oxygen saturation (ScvO2) and cerebral regional oxygen saturation (rScO2) pairs using Bland-Altman plots and Pearson correlations.
  • Evaluation of measurement bias between Black and White infants.

Main Results:

  • A total of 254 infants (13% Black, 87% White) provided 3,687 ScvO2-rScO2 pairs.
  • Measurement bias was -3.2% in Black infants versus +0.1% in White infants (p < 0.01).
  • Cerebral NIRS underestimated ScvO2 in Black infants but showed negligible bias in White infants.

Conclusions:

  • This is the first study demonstrating a statistically significant racial difference in NIRS accuracy in infants.
  • Cerebral NIRS underestimates oxygen saturation in Black infants compared to White infants.
  • While statistically significant, the observed bias is generally not considered clinically relevant.