Near-infrared spectroscopy (NIRS) and skin tone in children: A prospective cohort study.

IF 9.1 1区医学 Q1 ANESTHESIOLOGY

Anesthesiology Pub Date : 2025-08-29 DOI:10.1097/ALN.0000000000005738

Joseph R Starnes, Wendi Welch, Christopher Henderson, Stephen Hudson, Briana McVean, Scott Risney, George T Nicholson, Thomas P Doyle, Dana Janssen, Bevan P Londergan, David A Parra, James C Slaughter, Muktar H Aliyu, John A Graves, Jonathan H Soslow

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引用次数: 0

Abstract

Background: Retrospective studies suggest that pulse oximetry overestimates saturation in children from races that may be associated with darker skin tone. Near-infrared spectroscopy (NIRS) relies on similar optical technology, but less is known about the effect of skin tone on NIRS. We aimed to quantify the effect of skin tone on NIRS performance.

Methods: Consecutive patients under 21 years undergoing cardiac catheterization were enrolled (N=110). Skin tone was measured using spectrophotometry. Regional oxygen saturation was recorded from a Medtronic INVOS 5100C NIRS device placed on the forehead and was compared to the mixed venous saturation. Multivariable linear regressions were used to determine the effect of skin tone measured by individual typology angle (ITA).

Results: Mean bias was larger for patients with darker skin in ITA categories 5-6 at -12.8% compared to ITA 3-4 at -2.5% with a difference of 10.3% (95%CI[4.4, 16.3], p<0.001) and ITA 1-2 at 0.3% with a difference of 13.1% (95%CI[7.5, 18.7], p<0.001). ITA was associated with NIRS bias in multivariable regression analysis (coefficient 0.173, p<0.001).

Conclusions: Darker skin tone is associated with worse NIRS performance and lower NIRS values compared to mixed venous saturation for the INVOS 5100C system. This may lead to differences in care and contribute to inequities in outcomes. Better validation guidelines are needed to ensure equity in performance across varying skin tones.

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近红外光谱（NIRS）和儿童肤色：一项前瞻性队列研究。

背景：回顾性研究表明，脉搏血氧仪高估了来自肤色较深的种族的儿童的血饱和度。近红外光谱（NIRS）依赖于类似的光学技术，但人们对肤色对近红外光谱的影响知之甚少。我们的目的是量化肤色对近红外光谱性能的影响。方法：选取21岁以下连续行心导管置入术的患者110例。用分光光度法测定肤色。通过放置在额头上的美敦力INVOS 5100C近红外仪记录区域氧饱和度，并与混合静脉饱和度进行比较。使用多变量线性回归来确定个体类型角（ITA）测量的肤色的影响。结果：ITA类别5-6中肤色较深的患者的平均偏倚较大，为-12.8%，而ITA类别3-4为-2.5%，差异为10.3% （95%CI[4.4, 16.3]）。结论：与INVOS 5100C系统的混合静脉饱和度相比，肤色较深的患者NIRS表现较差，NIRS值较低。这可能导致护理方面的差异，并导致结果的不公平。需要更好的验证指南来确保不同肤色的性能平等。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anesthesiology 医学-麻醉学

CiteScore

10.40

自引率

5.70%

发文量

542

审稿时长

3-6 weeks

期刊介绍： With its establishment in 1940, Anesthesiology has emerged as a prominent leader in the field of anesthesiology, encompassing perioperative, critical care, and pain medicine. As the esteemed journal of the American Society of Anesthesiologists, Anesthesiology operates independently with full editorial freedom. Its distinguished Editorial Board, comprising renowned professionals from across the globe, drives the advancement of the specialty by presenting innovative research through immediate open access to select articles and granting free access to all published articles after a six-month period. Furthermore, Anesthesiology actively promotes groundbreaking studies through an influential press release program. The journal's unwavering commitment lies in the dissemination of exemplary work that enhances clinical practice and revolutionizes the practice of medicine within our discipline.