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Am J Perinatol
DOI: 10.1055/a-2714-3293
Original Article

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

Authors

  • Callie Marshall 

    1   Pediatrics, Washington University in St Louis, St. Louis, United States (Ringgold ID: RIN7548)

  • Stephanie Diggs

    1   Pediatrics, Washington University in St Louis, St. Louis, United States (Ringgold ID: RIN7548)

  • Morgan Pfeiffer

    1   Pediatrics, Washington University in St Louis, St. Louis, United States (Ringgold ID: RIN7548)

  • Anna Gerst

    1   Pediatrics, Washington University in St Louis, St. Louis, United States (Ringgold ID: RIN7548)

  • Alexa Brumfiel

    1   Pediatrics, Washington University in St Louis, St. Louis, United States (Ringgold ID: RIN7548)

  • Zachary A. Vesoulis

    2   Pediatrics, Washington University in Saint Louis School of Medicine, Saint Louis, United States (Ringgold ID: RIN12275)
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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 (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 ScvO<sub>2</sub> 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.



Publication History

Received: 21 April 2025

Accepted after revision: 30 September 2025

Accepted Manuscript online:
03 October 2025

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