Pulse oximetry interference

Pulse oximetry interference

S A Hussain. Pulse oximetry interference in bronze baby syndrome. J Perinatol (2009) ; 29, 828–829. Full Text | PDF

A case of a neonate with Rhesus hemolytic disease of the newborn who went on to develop bronze baby syndrome (BBS) is reported. During his admission, inconsistencies between pulse oximetry saturations (SpO₂) and his arterial partial pressure of oxygen (PaO₂) measurements raised the suspicion of interference with our SpO₂ monitoring. Although bilirubin has been heavily investigated with respect to SpO₂ interference, a brown pigment has been shown to be produced in patients with BBS, which exhibits spectral absorbances that may cause interference with the pulse oximeter. This needs further exploration, but highlights the need to interpret SpO₂ readings with caution in neonates with BBS.

Comments. Bronze baby syndrome is due to the accumulation of brown photopigments in plasma and tissues when babies with cholestasis are treated with phototherapy. This case report suggests that these brown pigments may interfere with the ability of pulse oximeters to give accurate readings. This occurred both with Phillips and Massimo type oximeters. In the case presented, the oximetry readings were consistantly ~ 85% even though the arterial pO2 was > 200. Practitioners should be aware of this possible issue when interpreting pulse oximetry values. ABK.

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