Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Feb 12;6(2):e1049.
doi: 10.1097/CCE.0000000000001049. eCollection 2024 Feb.

Impact of Skin Pigmentation on Cerebral Regional Saturation of Oxygen Using Near-Infrared Spectroscopy: A Systematic Review

Nikunj A Patel  1 , Harvir S Bhattal  2 , Donald E Griesdale  1 , Ryan L Hoiland  1   3   4   5   6 , Mypinder S Sekhon  5   6   7   8
Affiliations
Review

Impact of Skin Pigmentation on Cerebral Regional Saturation of Oxygen Using Near-Infrared Spectroscopy: A Systematic Review

Nikunj A Patel et al. Crit Care Explor. .

Abstract

Objectives: Near-infrared spectroscopy (NIRS) is used in critical care settings to measure regional cerebral tissue oxygenation (rSo2). However, the accuracy of such measurements has been questioned in darker-skinned individuals due to the confounding effects of light absorption by melanin. In this systematic review, we aim to synthesize the available evidence on the effect of skin pigmentation on rSo2 readings.

Data sources: We systematically searched MEDLINE, Cochrane Database of Systematic Reviews, Embase, and Google Scholar from inception to July 1, 2023.

Study selection: In compliance with our PROSPERO registration (CRD42022347548), we selected articles comparing rSo2 measurements in adults either between racial groups or at different levels of skin pigmentation. Two independent reviewers conducted full-text reviews of all potentially relevant articles.

Data extraction: We extracted data on self-reported race or level of skin pigmentation and mean rSo2 values.

Data synthesis: Of the 11,495 unique records screened, two studies (n = 7,549) met our inclusion criteria for systematic review. Sun et al (2015) yielded significantly lower rSo2 values for African Americans compared with Caucasians, whereas Stannard et al (2021) found little difference between self-reported racial groups. This discrepancy is likely because Stannard et al (2021) used a NIRS platform which specifically purports to control for the effects of melanin. Several other studies that did not meet our inclusion criteria corroborated the notion that skin pigmentation results in lower rSo2 readings.

Conclusions: Skin pigmentation likely results in attenuated rSo2 readings. However, the magnitude of this effect may depend on the specific NIRS platform used.

Keywords: cerebral oximetry; near-infrared spectroscopy; race; regional cerebral tissue oxygen saturation; skin pigmentation.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram—adult search. rSo2 = regional cerebral tissue oxygenation.
Figure 2.
Figure 2.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram—pediatric/neonate search. rSo2 = regional cerebral tissue oxygenation.
See this image and copyright information in PMC

References

    1. Vretzakis G, Georgopoulou S, Stamoulis K, et al. : Cerebral oximetry in cardiac anesthesia. J Thorac Dis 2014; 6:60–69 - PMC - PubMed
    1. Bickler PE, Feiner JR, Rollins MD: Factors affecting the performance of 5 cerebral oximeters during hypoxia in healthy volunteers. Anesth Analg 2013; 117:813–823 - PubMed
    1. Ito K, Ookawara S, Ueda Y, et al. : Factors affecting cerebral oxygenation in hemodialysis patients: Cerebral oxygenation associates with pH, hemodialysis duration, serum albumin concentration, and diabetes mellitus. PLoS One 2015; 10:e0117474. - PMC - PubMed
    1. Cabanas AM, Fuentes-Guajardo M, Latorre K, et al. : Skin pigmentation influence on pulse oximetry accuracy: A systematic review and bibliometric analysis. Sensors (Basel) 2022; 22:3402. - PMC - PubMed
    1. Liberati A, Altman DG, Tetzlaff J, et al. : The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ 2009; 339:b2700. - PMC - PubMed