Related Experiment Video
Updated: Jan 16, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Racial Variation in Cerebral Near-Infrared Spectroscopy Accuracy among Infants in a Cardiac Intensive Care Unit
Callie Marshall1, Stephanie Diggs1, Morgan Pfeiffer2
1Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, United States.
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 to 2023. Bland-Altman plots, Pearson correlations, and mean biases were analyzed.
Results:
About 254 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).
Conclusion:
Cerebral NIRS underestimates ScvO2 in Black infants but maintains negligible 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.
Key Points:
· Light-based measures of oxygen saturation risk interference from melanin.. · Bias of cerebral NIRS is low (-0.6%) against central venous oxygenation.. · Cerebral NIRS error is disproportionate by race, with an underestimate of 3.2% in Black infants..
