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
{"title":"近红外光谱（NIRS）和儿童肤色：一项前瞻性队列研究。","authors":"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","doi":"10.1097/ALN.0000000000005738","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.1000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Near-infrared spectroscopy (NIRS) and skin tone in children: A prospective cohort study.\",\"authors\":\"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\",\"doi\":\"10.1097/ALN.0000000000005738\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":7970,\"journal\":{\"name\":\"Anesthesiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":9.1000,\"publicationDate\":\"2025-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anesthesiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/ALN.0000000000005738\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anesthesiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/ALN.0000000000005738","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Near-infrared spectroscopy (NIRS) and skin tone in children: A prospective cohort study.
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.
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.
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